Bonnewyn Anke, Shah Ajit, Bruffaerts Ronny, Demyttenaere Koen
University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
University of Central Lancashire, Preston, UK.
Int Psychogeriatr. 2014 Oct;26(10):1693-1702. doi: 10.1017/S1041610214000957. Epub 2014 Jul 3.
Death wishes are not uncommon in older persons, and to date, several risk factors have been identified. The presence of these risk factors is insufficient to fully understand why some older people, who are exposed to them, develop a wish to die and why others do not. The purpose of the study was to explore whether Purpose in Life as well as other life attitudes are associated with a death wish in older males and females.
The sample comprised 113 older inpatients (from a psychiatric and somatic ward) with a mean age of 74 years. Psychiatric diagnoses were assessed by the SCID-II. Logistic regression analyses estimated the unique contribution of (the interaction between) life attitudes and gender to the wish to die, controlling for sociodemographic variables, depressive disorder, and somatic symptoms.
We observed a statistically significant relationship between life attitudes and the wish to die. Purpose in Life and the Purpose in Life*Gender interaction explained significant additional variance in the prediction of the wish to die. Purposelessness in life might therefore be an important correlate of a wish to die, especially in older men, independently from sociodemographic and clinical features.
In assessing a wish to die in older adults, life attitudes need to be taken into account, besides the presence of a depressive disorder and/or somatic health. More specifically, finding or maintaining a purpose in later life might be an important feature in the prevention of the wish to die, especially in male persons.
死亡意愿在老年人中并不罕见，迄今为止，已确定了若干风险因素。这些风险因素的存在不足以充分理解为什么一些接触到这些因素的老年人会产生死亡意愿，而另一些人却不会。本研究的目的是探讨生活目的以及其他生活态度是否与老年男性和女性的死亡意愿相关。
样本包括113名老年住院患者（来自精神科和躯体科病房），平均年龄74岁。采用SCID-II评估精神科诊断。逻辑回归分析估计了生活态度和性别（之间的相互作用）对死亡意愿的独特贡献，同时控制了社会人口统计学变量、抑郁症和躯体症状。
我们观察到生活态度与死亡意愿之间存在统计学上的显著关系。生活目的以及生活目的*性别相互作用在预测死亡意愿方面解释了显著的额外方差。因此，生活无目的可能是死亡意愿的一个重要相关因素，尤其是在老年男性中，独立于社会人口统计学和临床特征。
在评估老年人的死亡意愿时，除了存在抑郁症和/或躯体健康状况外，还需要考虑生活态度。更具体地说，在晚年找到或保持生活目的可能是预防死亡意愿的一个重要特征，尤其是在男性中。
