Citation

Alexopoulos GS, Bruce ML, Hull J. Prim. Care Companion J. Clin. Psychiatry 2000; 2(1): e32.

Copyright

(Copyright © 2000, Physicians Postgraduate Press)

DOI

unavailable

PMID

unavailable

Abstract

This study sought to discover clinical characteristics by which to recognize elderly patients with depression at risk for suicidal ideation and to establish their prognosis. Suicidal ideation, past suicidal behavior, severity of depression, cognitive impairment, medical burden, disability, and social support were evaluated in 354 subjects with depression aged 61 to 93 years. Patients had face-to-face evaluations and telephone assessments for a mean ± SD of 1.8 ± 2.2 years. Earlier suicide attempts with serious intent (OR = 2.82, 95% CI = 1.37 to 5.80), severity of depression (OR = 1.09, 95% CI = 1.03 to 1.16), and poor social support (OR = 1.77, 95% CI = 1.18 to 2.65) predicted suicidal ideation during the index period. Subjects with a severe index episode (OR = 1.05, 95% CI = 1.00 to 1.11), impaired instrumental activities of daily living (OR = 0.78, 95% CI = 0.67 to 0.93), and limited impairment in activities of daily living (OR = 1.53, 95% CI = 1.10 to 2.14) reported suicide attempts during the year before study entry. At the first assessment, severity of depression, previous attempts, and seriousness of suicidal intent predicted the course of suicidal ideation (concordance correlation, 0.78). During follow-up assessments, contemporaneous severity of depression was the strongest determinant of suicidal ideation over time (concordance correlation, 0.88). The elderly who experience severe depression, have a history of suicide attempts with serious intent, and have poor social support are the most likely to have suicidal ideation; such individuals should be the targets of suitable interventions. Severity of depression is the most important determinant of suicidal ideation over time. © Copyright 2000 Physicians Postgraduate Press, Inc.

Language: en