Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T08:45:19.525Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence and correlates of suicidal thought and self-destructive behavior among an elderly hospital population in Iran

Published online by Cambridge University Press:  14 March 2012

Sahra Ekramzadeh ,
Ali Javadpour ,
Brian Draper ,
Arash Mani ,
Adrienne Withall  and
Ali Sahraian
Sahra Ekramzadeh
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Ali Javadpour*
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Brian Draper
Affiliation:
School of Psychiatry, University of NSW, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
Arash Mani
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Adrienne Withall
Affiliation:
School of Psychiatry, University of NSW, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
Ali Sahraian
Affiliation:
Research Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
*
Correspondence should be addressed to: Ali Javadpour, MD, Research Centre for Psychiatry and Behavioral Sciences, Hafez Hospital, Shiraz, Iran. Phone: + 98 711 6273080; Fax: + 98 711 6273080. Email: javadpoura@sums.ac.ir.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Few studies have examined suicidal ideation and behavior in hospitalized physically ill elderly patients, a group potentially at high risk. Our aim was to investigate the prevalence and risk factors for suicide ideation, and direct and indirect self-destructive behaviors among a sample of elderly inpatients.

Methods: A cross-sectional study was conducted in 2009; 650 inpatients aged 60 years and over were screened from various medical services in teaching hospitals affiliated to Shiraz University of Medical Sciences in Iran. Suicidal ideation and behavior were measured with the Beck Scale for Suicidal Ideation (BSSI) and the Harmful Behavior Scale (HBS). Depression was measured with the Geriatric Depression Scale (GDS), medical burden with the geriatric version of the Cumulative Illness Rating Scale (CIRS-G), life events with the Paykel Life Event Scale, and social support with the Perceived Social Support Scale.

Result: Of the 650 patients screened with a mean age of 70.5 years (SD ± 7.5), 570 met inclusion criteria and of these 123 (21.6%) reported suicidal ideation on the BSSI and 80 (14.4%) had at least one self-destructive behavior included in the HBS. There was a significant correlation between suicide ideation and harmful behaviors (r = 0.503, p = 0.001). In a regression analysis, depressive symptoms, increased burden of medical conditions, marital status, history of substance use, history of traumatic life events, lack of perceived social support, and poor education were associated with both suicide ideation and harmful behavior. From demographic variables, living without a spouse and unemployment were predictors of suicidal ideation and behavior.

Conclusion: Hospitalized, physically ill elderly patients have high rates of suicidal ideation and self-destructive behavior and these vary according to psychosocial and clinical factors. The general hospital is therefore a potential site for the recognition of suicidal individuals and implementation of proximal suicide prevention strategies.

Keywords

suicidal ideationindirect self-destructive behaviorgeneral hospital
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 9 , September 2012 , pp. 1402 - 1408
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anisi, J., FathiI, A. A., Salimi, S. H. and Ahmadi, K. (2006). Assessing reliability and validity of Beck Suicide Scale among military soldiers. Journal of Military Medicine, 7, 33–37.Google Scholar
Awata, S. et al. (2005). Factors associated with suicidal ideation in an elderly urban Japanese population: a community-based, cross-sectional study. Psychiatry and Clinical Neurosciences, 59, 327–336.CrossRefGoogle Scholar
Callaghan, C. M., Hendrie, H. C., Nienaber, N. A. and Tierney, W. M. (1996). Suicidal ideation among older primary care patients. Journal of the American Geriatrics Society, 44, 1205–1209.CrossRefGoogle Scholar
Chan, J., Draper, B. and Banerjee, S. (2007). Deliberate self-harm in older adults: a review of the literature from 1995 to 2004. International Journal of Geriatric Psychiatry, 22, 720–732.CrossRefGoogle ScholarPubMed
Chen, C.-S. et al. (2008). Suicidal thoughts among elderly Taiwanese aboriginal women. International Journal of Geriatric Psychiatry, 23, 1001–1006.CrossRefGoogle ScholarPubMed
Cheung, Y. B., Law, C. K., Chan, B., Liu, K. Y. and Yip, P. S. F. (2006). Suicidal ideation and suicidal attempts in a population-based study of Chinese people: risk attributable to hopelessness, depression, and social factors. Journal of Affective Disorders, 90, 193–199.CrossRefGoogle Scholar
Conwell, Y., Pearson, J. and DeRenzo, E. G. (1996). Indirect self-destructive behavior among elderly patients in nursing homes: a research agenda. American Journal of Geriatric Psychiatry, 4, 152–163.CrossRefGoogle ScholarPubMed
Conwell, Y., Duberstein, P. R. and Caine, E. D. (2002). Risk factors for suicide in later life. Biological Psychiatry, 52, 193–204.CrossRefGoogle ScholarPubMed
De Leo, D., Padoani, W. and Scocco, P. (2001). Attempted and completed suicide in older subjects: results from the WHO/EURO multicentre study of suicidal behaviour. International Journal of Geriatric Psychiatry, 16, 300–310.CrossRefGoogle ScholarPubMed
De Leo, D., Padoani, W. and Lonnqvist, J. (2002). Repetition of suicidal behaviour in elderly Europeans: a prospective longitudinal study. Journal of Affective Disorders, 72, 291–295.CrossRefGoogle ScholarPubMed
Draper, B. (2010). Suicidal behaviour. In Abou-Saleh, M., Katona, C. and Kumar, A. (eds.), Principles and Practice of Geriatric Psychiatry, 3rd edn. (pp. 559–564). Chichester: Wiley-Blackwell.CrossRefGoogle Scholar
Draper, B., Brodaty, H., Low, L.-F., Richards, V., Paton, H. and Lie, D. (2002). Self destructive behaviours in nursing home residents. Journal of the American Geriatrics Society, 50, 354–358.CrossRefGoogle ScholarPubMed
Draper, B., Brodaty, H., Low, L.-F. and Richards, V. (2003). Prediction of mortality in nursing home residents: impact of self-destructive behaviours. International Psychogeriatrics, 15, 187–196.CrossRefGoogle Scholar
Folstein, M., Folstein, S. and McHugh, P. (1975). “Mini-mental state:” a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Forsell, Y., Jorm, A. F. and Winblad, B. (1997). Suicidal thoughts and associated factors in an elderly population. Acta Psychiatrica Scandinavia, 95, 108–111.CrossRefGoogle Scholar
Joiner, T. E. Jr. et al. (2005). Four studies on how past and current suicidality relate even when “everything but the kitchen sink” is covaried. Journal of Abnormal Psychology, 114, 291–303.CrossRefGoogle Scholar
Juurlink, D. N., Herrmann, N., Szalai, J. P., Kopp, A. and Redelmeier, D. A. (2004). Medical illness and the risk of suicide in the elderly. Archives of Internal Medicine, 164, 1179–1184.CrossRefGoogle ScholarPubMed
Kishi, Y., Robinson, R. G. and Kosier, J. T. (1996). Suicidal plans in patients with strokes: comparison between acute-onset and delayed-onset suicidal plans. International Psychogeriatrics, 8, 623–634.CrossRefGoogle ScholarPubMed
Liu, I.-C. and Chiu, C.-H. (2009). Case-control study of suicide attempts in the elderly. International Psychogeriatrics, 21, 896–902.CrossRefGoogle ScholarPubMed
Malakouti, S., Fatollahi, P., Mirabzadeh, A., Salavati, M. and Zandi, T. (2006). Reliability, validity and factor structure of the GDS-15 in Iranian elderly. International Journal of Geriatric Psychiatry, 21, 588–593.CrossRefGoogle ScholarPubMed
Miller, M. D., Paradis, C. F., Houck, P. R., Mazumdar, S. and Stack, J. A. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatric Research, 41, 237–248.CrossRefGoogle ScholarPubMed
Mitchell, A. J., Bird, V., Rizzo, M. and Meader, N. (2010). Which version of the Geriatric Depression Scale is most useful in medical settings and nursing homes? Diagnostic validity meta-analysis. American Journal of Geriatric Psychiatry, 18, 1066–1107.CrossRefGoogle ScholarPubMed
Morteza, M., Simin, M. and Behrouz, K. (1989). Ranking of traumatic life events among Shahid Beheshti Medical University students. Journal of Medical Faculty of Shahid Beheshti Medical University, 14, 33–48.Google Scholar
Owens, D., Horrocks, J. and House, A. (2002). Fatal and non-fatal repetition of self-harm: systematic review. British Journal of Psychiatry, 181, 193–199.CrossRefGoogle ScholarPubMed
Paykel, E., Prusoff, B. and Uhlenhuth, E. H. (1971). Scaling of life events. Archives of General Psychiatry, 25, 340–347.CrossRefGoogle ScholarPubMed
Paykel, E. S., Myers, J. K. and Lendenthal, J. J. (1974). Suicidal feelings in general population: a prevalence study. British Journal of Psychiatry, 124, 460–469.CrossRefGoogle ScholarPubMed
Quan, H., Arboleda-Florez, J., Fick, G. H., Stuart, H. L. and Love, E. J. (2002). Association between physical illness and suicide among the elderly. Social Psychiatry and Psychiatric Epidemiology, 37, 190–197.CrossRefGoogle ScholarPubMed
Rao, R., Dening, T., Brayne, C. and Huppert, F. (1997). Suicidal ideation in community residents over eighty. International Journal of Geriatric Psychiatry, 12, 337–343.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Shah, A., Hoxey, K. and Mayadunne, V. (2000) Suicidal ideation in acutely medically ill elderly inpatients: prevalence, correlates and longitudinal stability. International Journal of Geriatric Psychiatry, 15, 162–169.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Shah, A., Bhat, R., Mackenzie, S. and Koen, C. (2008). Elderly suicide rates: cross national comparisons of trends over a 10-year period. International Psychogeriatrics, 20, 673–686.CrossRefGoogle ScholarPubMed
Shah, A. K., Dighe-Deo, D. and Chapman, C. (1998). Suicial ideation among acutely medically ill elderly inpatients. Ageing & Mental Health, 2, 300–305.CrossRefGoogle Scholar
Skoog, I. et al. (1996). Suicidal feelings in a population sample of nondemented 85 year-olds. American Journal of Geriatric Psychiatry, 153, 1015–1020.Google Scholar
Yen, Y.-C. et al. (2005). Suicidal ideation and associated factors among community-dwelling elders in Taiwan. Psychiatry and Clinical Neurosciences, 59, 365–371.CrossRefGoogle ScholarPubMed
Yip, P. S. F., Chi, I., Chiu, H., Wai, K. C. and Conwell, Y. (2003). A prevalence study of suicide ideation among older adults in Hong Kong SAR. International Journal of Geriatric Psychiatry, 18, 1056–1062.CrossRefGoogle ScholarPubMed
Zimet, G. D., Dahlem, N., Zimet, S. G. and Farly, G. (1988). Multidimensional scale of perceived social support. Journal of Personality Assessment, 5, 30–41.CrossRefGoogle Scholar