Department of Psychiatry, The University of Hong Kong, Hong Kong.
East Asian Arch Psychiatry. 2021 Mar;31(1):3-8. doi: 10.12809/eaap2055.
To compare older adults with late-life depression (LLD) and healthy controls in terms of suicidal ideation during the COVID-19 pandemic, and to determine predictors of suicidal ideation.
Between March and April 2020, old adults diagnosed with major depressive disorder (single or recurrent episode) as defined by the DSM-5 were recruited from psychiatric clinics or inpatient wards, whereas 31 healthy older adults without a history of depression or other psychiatric illnesses were recruited from voluntary organisations or elderly community centres. Their depressive symptoms, perceived severity of the pandemic, perceived time spent on receiving related information, perceived health, levels of loneliness, perceived coping efficacy, suicidal ideation, and the level of symptomatic responses to a specific traumatic stressor in the past week were assessed.
In total, 21 men and 43 women aged 61 to 89 years were interviewed through telephone by trained research assistants. Of them, 33 were older adults with LLD (cases) and 31 were healthy older adults (controls). Older people with LLD had a higher level of suicidal ideation than healthy controls, after controlling for the level of depression and medical comorbidity (F (1, 59) = 5.72, p = 0.020). Regression analyses showed that coping efficacy and loneliness accounted for a significant portion of the variance in suicidal ideation, and loneliness significantly predicted the level of stress. Mediation analyses reveal an indirect effect between group and suicidal ideation through coping efficacy (Z = 2.43, p = 0.015).
Older people with LLD are at increased suicidal risk and require timely mental health support. Coping efficacy and loneliness are important predictors for suicidal ideation and stress.
在 COVID-19 大流行期间，比较患有老年期抑郁症（LLD）的老年人与健康对照者的自杀意念，并确定自杀意念的预测因素。
在 2020 年 3 月至 4 月期间，从精神病诊所或住院病房招募了被 DSM-5 定义为患有单相或复发性重性抑郁症的老年人，而 31 名没有抑郁症或其他精神疾病史的健康老年人则从自愿组织或老年人社区中心招募。评估他们的抑郁症状、对大流行严重程度的感知、花在接收相关信息上的时间、感知健康状况、孤独感、感知应对效能、自杀意念，以及过去一周对特定创伤性应激源的症状反应程度。
共有 33 名男性和 43 名年龄在 61 至 89 岁之间的老年人通过电话接受了经过培训的研究助理的访谈。其中，33 名是患有 LLD 的老年人（病例），31 名是健康的老年人（对照）。在控制了抑郁程度和医疗合并症后，患有 LLD 的老年人的自杀意念水平高于健康对照者（F（1，59）=5.72，p=0.020）。回归分析显示，应对效能和孤独感解释了自杀意念的很大一部分变异，孤独感显著预测了应激水平。中介分析显示，通过应对效能，组与自杀意念之间存在间接效应（Z=2.43，p=0.015）。
患有 LLD 的老年人自杀风险增加，需要及时的心理健康支持。应对效能和孤独感是自杀意念和应激的重要预测因素。
