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Older women who died by suicide: suicide means, sociodemographic and psychiatric risk factors, and other precipitating circumstances

Published online by Cambridge University Press:  21 March 2018

Namkee G. Choi ,
Diana M. DiNitto ,
Atami O. Sagna  and
C. Nathan Marti
Namkee G. Choi*
Affiliation:
The University of Texas at Austin Steve Hicks School of Social Work, Austin, Texas, USA
Diana M. DiNitto
Affiliation:
The University of Texas at Austin Steve Hicks School of Social Work, Austin, Texas, USA
Atami O. Sagna
Affiliation:
The University of Texas at Austin School of Nursing, Austin, Texas, USA
C. Nathan Marti
Affiliation:
The University of Texas at Austin Steve Hicks School of Social Work, Austin, Texas, USA
*
Correspondence should be addressed to: Namkee G. Choi, The University of Texas at Austin Steve Hicks School of Social Work, 1925 San Jacinto Blvd, D3500, Austin, Texas 78712, USA. Phone: +1-512-232-9590; Fax: +1-512-471-9600. Email: nchoi@austin.utexas.edu.
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Abstract

Background:

US suicide rates among older women have substantially increased over the past decade. We examined potential differences in sociodemographic and risk/precipitating factors among older female suicide decedents who died by drug overdose versus firearms, hanging/suffocation, and other means, and postmortem toxicology results by suicide means.

Methods:

Data are from the 2005 to 2015 US National Violent Death Reporting System (N = 12,401 female decedents aged 50 years and over). We used three logistic regression models, with overdose versus firearms, overdose versus hanging/suffocation, and overdose versus “other” means as the dependent variables, to examine associations between suicide means and sociodemographic and risk/precipitating factors. χ2 tests were used to examine positive toxicology of prescription and illicit drugs by suicide means.

Results:

Compared to firearm users, overdose users were younger and had higher odds of having had previous suicide attempts/intent disclosures, mental disorders (e.g. depression/dysthymia: AOR = 1.18, 95% CI = 1.05–1.34), and substance abuse other than alcohol, but lower odds of having had relationship problems and any crisis. Compared to hanging/suffocation, overdose declined (AOR = 0.95, 95% CI = 0.93–0.97) during the study period and was less prevalent among Hispanic and Asian women and those with job/finance/housing problems. Toxicology reports showed that 47%, 43%, and 45% of overdose users were antidepressant, opiate, and benzodiazepine positive, respectively. Firearm users had the lowest rates of positive toxicology results for these drugs.

Conclusions:

Suicide prevention should include limiting access to large quantities of prescription medications and firearms for those at risk of suicide. More effective mental health/substance abuse treatment and chronic illness management support are also needed.

Keywords

older female suicide decedentsdrug overdosefirearmshanging/suffocationpostmortem toxicology
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 10: Issue Theme: Mild Cognitive Impairment , October 2018 , pp. 1531 - 1540
Copyright
Copyright © International Psychogeriatric Association 2018 

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