Crestani Carlo, Masotti Vittoria, Corradi Natalia, Schirripa Maria Laura, Cecchi Rossana
Department of Biomedical, Biotechnological and Translational Sciences. Unit of Legal Medicine, Faculty of Medicine and Surgery, University of Parma, Italy.
Acta Biomed. 2019 Jan 22;90(1):68-76. doi: 10.23750/abm.v90i1.6312.
The rates of suicide increase with age and reach their highest levels in the oldest age groupings and are sufficiently large for them to constitute a public health concern. The number of deaths due to suicides after the age of 60 years in Italy is 1,775 (41.36%) in 2013; there is a constant increase of elder population over the last ten years and elderly are almost twice of young. It is in this context that suicide arises, a risk factor during old age.
This is a retrospective study of autopsy and police reports of suicide from January 1979 through December 2015. Data about suicides after the age of 60 years was collected from the Archives of the Legal Medicine of the University of Parma, a Northern Italian city. Trend and characteristics (age, sex, marital status, pathological factors and method of suicide) were assessed.
A total of 538 cases (394 males, 144 females) were identified. Male sex correlates to a higher suicidal risk, with a male-female ratio of 2.74:1. The highest risk of suicide is observed in the age between 70 and 79 years. Pathological factors were revealed in 427 cases (physical state for 194 cases, mental state for 233 cases); mental illness was related significantly to suicidal risk. Hanging is the most common suicide method (175 cases), followed by fall from height (130 cases), drowning (101 cases) and use of firearms (56 cases); differences regarding methods employed were detected between males and females. The choice of method sometimes is indicative of a clear decision, while other times it is strictly linked to the availability of the means.
Suicidal behavior seems to be the product of the interaction of many factors, such as biological or psychological diseases or painful events. The presence of chronic and debilitating diseases, often accompanied by profound psychological suffering, is a powerful stimulus for suicide among men, whereas mental state is a significant risk factor for women, with the majority suffering from depression. The psychological and the biological changes, the cognitive deficits and the common diseases facilitate the structuring of depressive characteristics.
自杀率随年龄增长而上升，在最年长的年龄组中达到最高水平，其规模足以引起公共卫生关注。2013年意大利60岁以上人群的自杀死亡人数为1775人（占41.36%）；在过去十年中，老年人口持续增加，老年人数量几乎是年轻人的两倍。自杀正是在这种背景下出现的，它是老年期的一个风险因素。
这是一项对1979年1月至2015年12月自杀尸检报告和警方报告的回顾性研究。60岁以上自杀者的数据来自意大利北部城市帕尔马大学法医学档案馆。评估了自杀趋势和特征（年龄、性别、婚姻状况、病理因素和自杀方式）。
共识别出538例（男性394例，女性144例）。男性自杀风险更高，男女比例为2.74:1。70至79岁年龄段的自杀风险最高。427例发现有病理因素（身体状况194例，精神状况233例）；精神疾病与自杀风险显著相关。上吊是最常见的自杀方式（175例），其次是高处坠落（130例）、溺水（101例）和使用枪支（56例）；男性和女性在使用的自杀方式上存在差异。自杀方式的选择有时表明是明确的决定，而其他时候则与手段的可得性密切相关。
自杀行为似乎是多种因素相互作用的产物，如生物或心理疾病或痛苦事件。慢性和使人衰弱的疾病的存在，往往伴随着深刻的心理痛苦，是男性自杀的强大诱因，而精神状态是女性的一个重要风险因素，大多数女性患有抑郁症。心理和生物变化、认知缺陷和常见疾病促进了抑郁特征的形成。
