Predictors of a suicidal behavior in patients with dementia

Abstract

Introduction

Cognitive disorders are associated with a wide range of psychopathological syndromes and behavioral disorders, and suicidal manifestations in dementia are understudied nowadays.

Objectives

To investigate clinical-psychopathological predictors of a suicidal behavior in patients with dementia.

Methodology

Forty-four patients with dementia were examined: 23 patients with suicidal manifestations and 21 patients without them (control group). Clinical and psychometrical methods were used: Mini Mental State Examination (MMSE) scale; Assessment of Suicide Risk scale; Hamilton Rating Scale for Depression (HDRS), and statistical ones.

Results

It was determined that male patients with dementia had suicidal behavioral manifestations more often than female patients (69.6%; P < 0.05). An average age of the patients was 69.88 ± 1.85 years with no significant difference between the main and control groups.

The majority of the patients with dementia (52.3%) had suicidal manifestations. Real suicidal intentions were the most frequent (25%; P < 0.05); 20.5% of patients expressed passive thoughts (anti-vital sentences, fantasies, ideas concerning death); 2 patients (6.82%; P < 0.05) had suicidal attempts. Patients with suicidal tendencies in their clinical picture more often had hallucinatory syndrome (39.1%; P < 0.05); features of severe depression (35.04 ± 1.54 points; P < 0.01); a high level of suicidal risk (26.34 ± 1.68 points; P < 0.01); a severe cognitive deficit (ММSE score 0–10); and a significantly lower level of self-awareness of death (18.53 ± 0.72 points; P < 0.05) in comparison with the control group.

Conclusions

A high suicide risk in dementia correlated with a level of depressive symptoms (r = 0.6), moderate and/or severe grades of dementia (r = 0.45), and a low level of self-awareness of death (r = 0.35).

Disclosure of interest

The authors have not supplied their declaration of competing interest.