Richardson R, Lowenstein S, Weissberg M
University of Colorado School of Medicine.
Geriatrics. 1989 Sep;44(9):43-7, 51.
Advancing age is associated with a markedly increased risk of suicide. In the United States, one fourth of all suicides are carried out by citizens age 60 or older. The majority of American elders who commit suicide use a firearm to do so. Most suicidal elders look to their primary care physician for help, although they may not directly express their plan. Therefore, physicians must be alert to clues. By far the principal risk factor for suicide is major depression. The risk is heightened by recent losses, alcohol or drug abuse, psychosis, cognitive decline, and chronic disease. Hopelessness, anhedonia, self-reproach, guilt, and a formed lethal plan are signs of a life-threatening suicidal crisis which requires urgent intervention. Physicians must act decisively in recognition of the fact that suicidality is a transient, treatable condition.
年龄增长与自杀风险显著增加相关。在美国，所有自杀事件中有四分之一是由60岁及以上的公民实施的。大多数自杀的美国老年人使用枪支自杀。大多数有自杀倾向的老年人会向他们的初级保健医生寻求帮助，尽管他们可能不会直接表达自己的计划。因此，医生必须留意线索。到目前为止，自杀的主要风险因素是重度抑郁症。近期的损失、酗酒或药物滥用、精神病、认知衰退和慢性病会增加这种风险。绝望、快感缺失、自责、内疚以及已形成的致命计划是危及生命的自杀危机的迹象，需要紧急干预。医生必须果断行动，认识到自杀倾向是一种短暂的、可治疗的状况。
