Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden.
J Affect Disord. 2011 Nov;134(1-3):333-40. doi: 10.1016/j.jad.2011.06.010. Epub 2011 Jul 6.
Most elderly persons who attempt suicide suffer from depression. This study aimed to investigate one-year outcomes in suicide attempters aged 70+, and to identify predictors of these outcomes.
101 persons (mean age 80) who were hospitalized after a suicide attempt were interviewed at baseline and followed for one year by record linkage. Face-to-face interviews were carried out with 71% of those who were alive after one year (60 out of 85). Outcome measures included major/minor depression, Montgomery-Asberg Depression Rating Scale (MADRS) score, repeat non-fatal/fatal suicidal behavior and all-cause mortality.
One half (52%) of all those who were interviewed scored <10 on the MADRS at follow-up. Among those with major depression at baseline, two thirds (26 out of 39) no longer fulfilled criteria for this disorder. Factors associated with non-remission of major depression (MADRS ≥ 10) included higher baseline depression and anxiety scores, higher suicide intent and lower Sense of Coherence. There were two suicides and six non-fatal repeat attempts. The relative risk of death (any cause) was 2.53 (95% CI = 1.45-4.10, p<0.001).
This is a naturalistic study; participants received non-uniform treatment as usual. The proportion with repeat suicidal behavior was lower than anticipated and the study was thus underpowered with regard to this outcome.
Half of the surviving attempters were free from depressive symptoms at one-year follow-up and there were relatively few repeat attempts. However, all cause mortality remained high in this elderly cohort.
大多数试图自杀的老年人都患有抑郁症。本研究旨在调查 70 岁以上自杀未遂者的一年结局，并确定这些结局的预测因素。
101 名（平均年龄 80 岁）在自杀未遂后住院的患者在基线时接受了访谈，并通过记录链接进行了为期一年的随访。对一年后仍存活的 85 名患者中的 71%（60 名）进行了面对面访谈。结局测量包括主要/轻度抑郁、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）评分、重复非致命/致命自杀行为和全因死亡率。
在接受访谈的所有患者中，有一半（52%）在随访时 MADRS 评分<10。在基线时有重度抑郁症的患者中，三分之二（26 名患者中的 39 名）不再符合该疾病的标准。与重度抑郁症未缓解（MADRS≥10）相关的因素包括较高的基线抑郁和焦虑评分、较高的自杀意图和较低的心理一致感。有两例自杀和六例非致命性重复自杀未遂。死亡（任何原因）的相对风险为 2.53（95%可信区间为 1.45-4.10，p<0.001）。
这是一项自然主义研究；参与者接受的是非标准化的常规治疗。重复自杀行为的比例低于预期，因此该研究在这一结局方面的效力不足。
在一年的随访中，一半的存活未遂者没有抑郁症状，重复自杀尝试相对较少。然而，在这个老年队列中，全因死亡率仍然很高。
