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Abstract
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INTRODUCTION: Based on available literature, early psychiatric assessment and vigorous treatment could prevent many suicides in old age. Some studies reported that 80% of the elderly who committed suicide received no psychiatric referral and 15% of elderly suicide victims were under psychiatric care at the time of death. In this study, we attempt to explore the characteristics of elderly suicide victims who were known to psychiatric services compared to those who were not. The findings and possible clinical implications are discussed.
METHODS: Data was extracted from the records of coroner's inquests into all unexpected deaths of persons aged 60 and over, in Cheshire over a period of 13 years 1989-2001. The coroner's office covers the whole county of Cheshire (1 000 000 population). Verdicts of accidental death, misadventure and open verdicts were not included in data collection.
RESULTS: The study found that male suicide victims were less likely to be known to services [odds ratio (OR) 0.4, 95% confidence interval (CI) 0.2-0.7, P < 0.001]. Those who were known to services were less likely to be living alone or leave a note (OR 0.3, 95% CI 0.2-0.6, P < 0.001). Significantly fewer widowed older adults who committed suicide were known to psychiatric services (OR 0.3, 95% CI 0.2-0.7, P < 0.001). Suicide victims who were known to services were more likely to have contacted their GP prior to their death (OR 2.3, 95% CI 1.2-4.4, P < 0.001). History of deliberate self-harm was significantly higher amongst those who were known to services (OR 3, 95% CI 1.5-6, P < 0.001).
CONCLUSION: Elderly suicide victims who were not known to psychiatric services tend to be a socially isolated group who harbour undetected psychiatric morbidity and are likely to succeed in their first attempt. The role of primary care services in reducing the suicide rate among this age group cannot be overemphasized. This also applies for those victims who are known to psychiatric services who would still rather contact their GPs in the last few weeks before the fatal act.
Language: en |