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Severity of Suicidal Ideation and Mortality in Older Adults: Theoretical and Clinical Implications

  • Patrick J. Raue
    Correspondence
    Send correspondence and reprint requests to Patrick J Raue, Ph.D., Department of Psychiatry & Behavioral Sciences, 1959 NE Pacific St., Box 356560, Seattle, WA 98195.
    Affiliations
    Professor in the Department of Psychiatry and Behavioral Sciences (PJR), University of Washington, Seattle, WA
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Published:November 11, 2022DOI:https://doi.org/10.1016/j.jagp.2022.11.003
      The prospective cohort study by Jonson et al
      • Jonson M
      • Sigstrom R
      • Van Orden K
      • et al.
      Life-weariness, wish to die, active suicidal ideation, and all-cause mortality in population-based samples of older adults.
      in this issue examined the impact of different levels of suicidal ideation on the 3-year all-cause mortality of 2,438 older adults (aged 79+) in Sweden. Previous work has documented that a variety of indicators of suicidal ideation, such as death wishes, are related to mortality in older adults.
      • Batterham PJ
      • Calear AL
      • Mackinnon AJ
      • et al.
      The association between suicidal ideation and increased mortality from natural causes.
      • Fagerström C
      • Welmer AK
      • Elmståhl S
      • et al.
      Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years.
      • Raue PJ
      • Morales KH
      • Post EP
      • et al.
      The wish to die and 5-year mortality in elderly primary care patients.
      The current study increases our understanding of possible unique relationships between different levels of passive and active suicidal ideation and mortality. Conceptualizing different gradients of passive suicidal ideation in particular, such as life weariness and wishes to be dead, provides an opportunity to uncover a more fine-grained understanding of these relationships. Life weariness as a less severe variant of passive suicidal ideation than wish to die is an interesting construct–one which may historically be more represented on research scales in comparison to clinical practice. But as the authors point out, these distinctions may be of both theoretical and clinical interest.
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      References

        • Jonson M
        • Sigstrom R
        • Van Orden K
        • et al.
        Life-weariness, wish to die, active suicidal ideation, and all-cause mortality in population-based samples of older adults.
        Am J Geriatr Psychiatry. 2022;
        • Batterham PJ
        • Calear AL
        • Mackinnon AJ
        • et al.
        The association between suicidal ideation and increased mortality from natural causes.
        J Affect Disord. 2013; 150 (Epub 2013 Apr 23. PMID: 23618327): 855-860https://doi.org/10.1016/j.jad.2013.03.018
        • Fagerström C
        • Welmer AK
        • Elmståhl S
        • et al.
        Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years.
        BMC Public Health. 2021; 21 (PMID: 34243751; PMCID: PMC8268207): 1359https://doi.org/10.1186/s12889-021-11329-z
        • Raue PJ
        • Morales KH
        • Post EP
        • et al.
        The wish to die and 5-year mortality in elderly primary care patients.
        Am J Geriatr Psychiatry. 2010; 18 (PMID: 19910882; PMCID: PMC2838995): 341-350https://doi.org/10.1097/JGP.0b013e3181c37cfe