Department of Psychiatry (OBE, WK, SK), University of Pittsburgh School of Medicine, Pittsburgh, PA.
Department of Psychology (BM), University of Southern Mississippi, Hattiesburg, MS.
Am J Geriatr Psychiatry. 2023 Jun;31(6):415-424. doi: 10.1016/j.jagp.2022.12.192. Epub 2022 Dec 30.
Suicide is an outcome arising from a combination of risk and protective factors. Examining psychological resilience traits associated with successful aging may help to better understand late-life suicide and depression. We examined self-reported protective factors including mindfulness, life satisfaction and engagement, flourishing, and subjective and objective social support in a high suicide-risk sample of depressed older adults.
Participants were 297 individuals aged 55+ (mean age: 64.2): 92 depressed suicide attempters, 138 depressed individuals who never attempted suicide, and 67 non-psychiatric comparisons. Using linear and binomial logistic regression, we examined the effects of a combined Protective Factor value on presence and severity of depression and suicidal ideation, and history of suicide attempt.
Relative to the non-psychiatric comparison group, all depressed participants had significantly lower Protective Factor values. Higher Protective Factor value was associated with lower likelihood of depression, depression severity, and likelihood of ideation, but was not associated with ideation severity or history of suicide attempt. Participants with one standard deviation higher Protective Factor had lower odds of ideation incidence by a factor of OR=0.68 (95%CI=0.48-0.96).
Resiliency characteristics relevant to psychological wellbeing and successful aging may mitigate the emergence of depression and suicidal ideation, as well as the severity of depression in late-life. The Resilience Factor used in this study can help clinicians nuance their appraisal of depression and suicide risk.
自杀是风险和保护因素共同作用的结果。研究与成功老龄化相关的心理弹性特征,可能有助于更好地理解老年人的自杀和抑郁问题。我们考察了在高自杀风险的抑郁老年人群体中,与正念、生活满意度和参与度、繁荣、主观和客观社会支持相关的自我报告保护因素。
参与者为 297 名年龄在 55 岁以上(平均年龄:64.2 岁)的个体:92 名抑郁自杀未遂者、138 名从未尝试自杀的抑郁者和 67 名非精神科对照者。我们使用线性和二项逻辑回归,考察了综合保护因素值对抑郁和自杀意念的存在和严重程度以及自杀未遂史的影响。
与非精神科对照组相比,所有抑郁患者的保护因素值明显较低。较高的保护因素值与较低的抑郁、抑郁严重程度和自杀意念发生几率相关,但与自杀意念严重程度或自杀未遂史无关。保护因素值增加一个标准差,自杀意念发生率的优势比(OR)降低 0.68(95%置信区间 [CI]:0.48-0.96)。
与心理幸福感和成功老龄化相关的弹性特征可能会减轻老年期抑郁和自杀意念的出现,以及抑郁的严重程度。本研究中使用的“弹性因子”可以帮助临床医生更细致地评估抑郁和自杀风险。