Citation

Dombrovski AY, Szanto K. Ann. Longterm Care 2005; 13(12): 25-32.

Copyright

(Copyright © 2005, HMP Communications)

DOI

unavailable

PMID

unavailable

Abstract

The suicide rate among U.S. elderly (age 65 and older) is higher than in any other age group. Severe and recurrent mood disorders, particularly unipolar and bipolar depression, are associated with the highest suicide risk. Medical conditions linked to a higher risk of suicide include severe pain, visual impairment, neurological illness, and malignancy. The combination of improved detection of depression with collaborative treatment, including antidepressants and manualized psychotherapy, is currently the best-supported strategy for suicide prevention in the elderly, but evidence remains limited. Telephone support and emergency alarm service also have promise. In younger adults and mixedage samples, lithium and electroconvulsive therapy were shown to decrease long-term and short-term suicide risk, respectively, in individuals with severe mood disorders. In most studies, clozapine was demonstrated to reduce suicidal behaviors in persons with schizophrenia. These treatments also are effective in treating mood disorders and psychosis in older adults. There is a great need for large long-term trials testing the effectiveness of interventions in elderly persons at high risk for suicide.

Language: en

Keywords

human; suicide; aging; psychotherapy; schizophrenia; major depression; lithium; bipolar depression; disease severity; clozapine; mood disorder; pain; visual impairment; risk factor; review; antidepressant agent; disease association; epidemiological data; groups by age; recurrent disease; electroconvulsive therapy; telephone; clinical protocol; prophylaxis; evidence based medicine; malignant neoplastic disease; neurological complication; alarm monitor