Department of Psychiatry and Neurochemistry, Neuropshychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Stockholm, Sweden.
Am J Geriatr Psychiatry. 2010 Jan;18(1):57-67. doi: 10.1097/JGP.0b013e3181bd1c13.
To identify factors associated with attempted suicide in the elderly.
Social, psychological, and psychiatric characteristics were compared in suicide attempters (70 years and older) and a representative population sample.
Emergency departments at five hospitals in western Sweden and a representative sample of the elderly population.
Persons with Mini Mental State Examination (MMSE) score <15 were excluded. One hundred forty persons who sought hospital treatment after a suicide attempt were eligible and 103 participated (57 women, 46 men, and mean age 80 years). Comparison subjects matched for gender and age group (N = 408) were randomly selected among participants in our general population studies.
Symptoms were rated with identical instruments in cases and comparison subjects. The examination included the MMSE and tests of short- and long-term memory, abstract thinking, aphasia, apraxia, and agnosia. Depressive symptomatology was measured using the Montgomery-Asberg Depression Rating Scale, and major and minor depressions were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using symptom algorithms.
Factors associated with attempted suicide included being unmarried, living alone, low education level, history of psychiatric treatment, and previous suicide attempt. There was no association with dementia. Odds ratios were increased for both major (odds ratio [OR]: 47.4, 95% confidence interval [CI]: 19.1-117.7) and minor (OR: 2.6, 95% CI: 1.5-4.7) depressions. An association was observed between perceived loneliness and attempted suicide; this relationship was independent of depression (OR: 2.8, 95% CI: 1.3-6.1).
Observed associations mirrored those previously shown for completed suicide. Results may help to inform clinical decisions regarding suicide risk evaluation in this vulnerable and growing age group.
确定与老年人自杀未遂相关的因素。
在自杀未遂者（70 岁及以上）和具有代表性的老年人群样本中比较社会、心理和精神科特征。
瑞典西部五家医院的急诊室和具有代表性的老年人群样本。
排除 Mini 精神状态检查（MMSE）评分<15 的人。有 140 名因自杀未遂而寻求医院治疗的人符合条件并参与了研究（57 名女性，46 名男性，平均年龄 80 岁）。随机选择我们一般人群研究中的参与者，按性别和年龄组匹配对照受试者（N=408）。
在病例和对照受试者中使用相同的工具评定症状。检查包括 MMSE 和短、长期记忆、抽象思维、失语症、失用症和失认症测试。使用蒙哥马利-阿斯伯格抑郁评定量表测量抑郁症状，根据精神障碍诊断与统计手册，第四版，使用症状算法诊断主要和次要抑郁。
与自杀未遂相关的因素包括未婚、独居、低教育水平、精神科治疗史和既往自杀未遂。与痴呆症无关。主要抑郁（优势比[OR]：47.4，95%置信区间[CI]：19.1-117.7）和次要抑郁（OR：2.6，95% CI：1.5-4.7）的比值比均增加。孤独感与自杀未遂之间存在关联；这种关系独立于抑郁（OR：2.8，95% CI：1.3-6.1）。
观察到的关联与以前显示的与自杀完成相关的关联相似。这些结果可能有助于为这个脆弱且不断增长的年龄组提供有关自杀风险评估的临床决策信息。
