Innamorati Marco, Pompili Maurizio, Di Vittorio Cristina, Baratta Stefano, Masotti Vittoria, Badaracco Annalisa, Conwell Yeates, Girardi Paolo, Amore Mario
Department of Neurosciences Division of Psychiatry, University of Parma, Parma, Italy.
Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Am J Geriatr Psychiatry. 2014 Nov;22(11):1158-67. doi: 10.1016/j.jagp.2013.03.003. Epub 2013 Jul 24.
To investigate factors differentiating old-old elderly (those aged 75 years and older) who died by suicide from middle-aged (those aged 50-64 years) and young-old (aged 65-74 years) adults who took their own lives, and from living psychiatric outpatients 75 years and older who had no suicidal behaviors in the last 12 months before assessment.
Cases for psychological autopsy interviews were 117 old-old elderly who died by suicide between 1994 and 2009. Comparisons were 97 young-old adult and 98 middle-aged suicide victims and 117 psychiatric outpatients admitted to the Department of Psychiatry of the University of Parma (Parma, Italy) between 1994 and 2009. Information for suicide decedents was gathered through proxy-based interviews, and data regarding living comparison subjects were extracted from medical records.
A high number of old-old elderly were widowed and lived alone before death; widowhood was more prevalent in the old-old elderly than in the younger suicide groups and the psychiatric outpatients. In addition, old-old elderly were more frequently characterized by the presence of life stressors in the few months before death compared with the psychiatric outpatients.
Clinicians involved in the prevention of suicide in older adults should pay particular attention to loneliness and lack of social support, two conditions that may push the individual to feel hopeless, especially in those individuals who are facing stressful life events.
调查区分75岁及以上的高龄老年人自杀与50 - 64岁的中年人及65 - 74岁的年轻老年人自杀的因素，以及与评估前12个月内无自杀行为的75岁及以上精神科门诊患者的差异。
心理解剖访谈的案例为1994年至2009年间117名自杀身亡的高龄老年人。对照组为97名年轻老年人自杀受害者、98名中年自杀受害者以及1994年至2009年间在意大利帕尔马大学精神科住院的117名精神科门诊患者。通过基于代理人的访谈收集自杀死者的信息，从医疗记录中提取有关在世对照对象的数据。
大量高龄老年人在死前丧偶且独居；丧偶在高龄老年人中比在年轻自杀组和精神科门诊患者中更为普遍。此外，与精神科门诊患者相比，高龄老年人在死前几个月更频繁地出现生活应激源。
参与预防老年人自杀的临床医生应特别关注孤独和缺乏社会支持这两个因素，这两种情况可能会使个体感到绝望，尤其是在那些面临压力性生活事件的个体中。
