Suicide in the Elderly: A Psychological Autopsy Study in a North Italy Area (1994–2004)

From the McLean Hospital, Harvard Medical School, Boston, MA (MP); Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Italy (MP, RT, PG); Università Europea di Roma, Italy (MI); Dipartimento di Anatomia umana, Farmacologia e Scienze Medico Forensi, Sezione di Medicina Legale, University of Parma, Italy (VM, FP); The Richard Stockton College of New Jersey, NJ (DL); and Department of Neurosciences, Division of Psychiatry, University of Parma, Italy (CDV, MA).

Address correspondence and reprint requests to: Maurizio Pompili, M.D., E-mail: maurizio.pompili{at}uniroma1.it; mpompili@mclean.harvard.edu.

	Abstract

Objectives: The aim of the present cross-sectional study was to evaluate the role of several variables hypothesized in previous research to be associated with suicide in older adults. Design: Psychological autopsy study. Setting: Suicides who were resident in the province of Parma and Piacenza and who died between 1994 and 2004. Participants: Ninety-nine elderly suicides (age 65 years; 77 men and 22 women) and 134 younger comparison suicides (115 men and 19 women). Younger victims were subdivided in two more homogeneous groups: young adults (age <36 years) and adults (age: 36–64 years). Measurements: Direct proxy-based interviews with relatives and family physicians. Results: Elderly victims were nine times (OR = 9.09; 95% CI: 1.32-62.63) more likely to live alone, 26 times (OR = 26.76; 95% CI: 9.04-79.24) more likely to be retired, and 14 times (OR = 14.57; 95% CI: 2.48-85.65) more likely to have attended school for no more than 5 years than adult suicides. Although, more than 50% of older suicides were diagnosed as DSM–IV–TR depressed, only 20%–30% of them had been treated with medications. Conclusion: Diverse patterns of risk factors for suicide have to be evaluated in older adults. Physicians must be aware that the concomitant presence of depressive symptoms and several life events (especially loss and loneliness in women and physical illness in men) should be considered warning signs for suicidal behavior.

Key Words: Suicide, elderly, psychological autopsy, prevention