Citation

Miret M, Nuevo R, Morant C, Sainz-Cortón E, Jiménez-Arriero MA, López-Ibor JJ, Reneses B, Saiz-Ruiz J, Baca-Garcia E, Ayuso-Mateos JL. Am. J. Geriatr. Psychiatry 2010; 18(9): 839-847.

Affiliation

Psychiatry Department, Autonoma University of Madrid, La Princesa University Hospital, Madrid; Instituto de Salud Carlos III, Centro de Investigacion Biomedica en Red de Salud Mental; Department of Mental Health, Madrid Regional Health Council; Psychiatry Department, Gregorio Maranon University Hospital, Madrid; Psychiatry Department, 12 de Octubre University Hospital, University Complutense, Madrid; Institute of Psychiatry and Mental Health, San Carlos University Hospital, University Complutense, Madrid; Psychiatry Department, Ramon y Cajal University Hospital, University of Alcala, Madrid; Department of Psychiatry, Fundacion Jimenez Diaz, Autonoma University of Madrid, Spain; and Psychiatry Department, Columbia University, New York.

Copyright

(Copyright © 2010, American Association for Geriatric Psychiatry, Publisher Elsevier Publishing)

DOI

10.1097/JGP.0b013e3181d145b0

PMID

20220600

Abstract

OBJECTIVE:: To analyze differences in the variables associated with severity of suicidal intent and in the main factors associated with intent when comparing younger and older adults. DESIGN:: Observational, descriptive cross-sectional study. SETTING:: Four general hospitals in Madrid, Spain. PARTICIPANTS:: Eight hundred seventy suicide attempts by 793 subjects split into two groups: 18-54 year olds and subjects older than 55 years. MEASUREMENTS:: The authors tested the factorial latent structure of suicidal intent through multigroup confirmatory factor analysis for categorical outcomes and performed statistical tests of invariance across age groups using the DIFFTEST procedure. Then, they tested a multiple indicators-multiple causes (MIMIC) model including different covariates regressed on the latent factor "intent" and performed two separate MIMIC models for younger and older adults to test for differential patterns. RESULTS:: Older adults had higher suicidal intent than younger adults (z = 2.63, p = 0.009). The final model for the whole sample showed a relationship of intent with previous attempts, support, mood disorder, personality disorder, substance-related disorder, and schizophrenia and other psychotic disorders. The model showed an adequate fit (chi[12] = 22.23, p = 0.035; comparative fit index = 0.986; Tucker-Lewis index = 0.980; root mean square error of approximation = 0.031; weighted root mean square residual = 0.727). All covariates had significant weights in the younger group, but in the older group, only previous attempts and mood disorders were significantly related to intent severity. CONCLUSIONS:: The pattern of variables associated with suicidal intent varies with age. Recognition, and treatment of geriatric depression may be the most effective measure to prevent suicidal behavior in older adults.

Language: en