Evaluation of socio-demographic factors and attempted suicides in the elderly

Year 2021, Volume: 6 Issue: 1, 43 - 48, 03.04.2021

Sinan Yenal Ahu Pakdemirli Başak Bayram Neşe Direk

https://doi.org/10.22391/fppc.803404

Abstract

Introduction: The aim of this study is to reveal the socio-demographic and certain clinical characteristics of elderly patients admitted to the emergency department after a suicide attempt.
Methods: This is a cross-sectional study. The universe of the study consisted of 96 patients aged 60 and over who were admitted to emergency department of Izmir Dokuz Eylul University Hospital between 2015-2019 due to a suicide attempt. Information for the study was obtained by retrospectively scanning the files of the patients.
Results: Mean age of the 96 patients included in the study was 68.22 ± 9.45 years. The most common suicide method among the patients was drug overdose (n: 59, 61.45%). It was found that 45.05% of the patients who attempted suicide had a known psychiatric diagnosis (n:41). The suicide rate of women (n:42, 43.75%) who were primary school graduates (p=0.026), had a known psychiatric illness (p=0.001), continuously used drugs (p=0.002) and used antidepressants (p<0.001) was significantly higher compared to men (n:54, 56.25%).
Conclusion: Being a primary school graduate, having a psychiatric illness, and using antidepressants increase suicide rates in women. It was suggested that this group of patients with suicidal tendencies should be treated with more care in emergency department.

Keywords

Emergency department, suicide, aged patient, risk factors

İntihar girişiminde bulunan yaşlılarda sosyo-demografik etmenlerin değerlendirilmesi

Abstract

Giriş: İntihar girişimi nedeni ile acil servise başvuran yaşlı hastaların sosyo-demografik ve belirli klinik özelliklerini ortaya koymaktır.
Yöntem: Kesitsel tipte planlanmış bir araştırmadır. Çalışmanın evreni; İzmir Dokuz Eylül Üniversite Hastanesi acil servisine, 2015-2019 yılları arası, intihar girişimi nedeniyle başvuran 60 yaş ve üzeri toplam 96 hastadan oluşmuştur. Çalışma için bilgiler hastaların dosyaları geriye dönük olarak taranarak elde edilmiştir.
Bulgular: Çalışmaya alınan toplam 96 hastanın yaş ortalaması 68,22±9,45 olarak hesaplanmıştır. İntihar yöntemi olarak hastalar en çok ilaç içme yöntemini (n:59, %61,45) kullandıkları görülmüştür. İntihar girişiminde bulunan hastaların %45,05’inin bilinen bir psikiyatrik hastalık tanısı olduğu bulunmuştur (n:41). İlkokul mezunu olan (p=0,026), bilinen bir psikiyatrik hastalığı bulunan (p=0,001), sürekli ilaç kullanan (p=0,002) ve antidepresan kullanan (p<0,001) kadınların (n:42, %43,75) intihar oranı erkeklere (n:54, %56,25) göre istatistiksel olarak anlamlı derecede yüksek bulunmuştur.
Sonuç: Kadınlarda, ilkokul mezunu olmak, psikiyatrik hastalığı bulunmak ve antidepresan kullanmanın intihar oranını arttırdığı görülmüştür. İntihara meyilli bu grup hastalar için acil servislerde daha özenli davranılması gerektiği önerilmiştir.  

Keywords

Acil servis, intihar, yaşlı hasta, risk faktörleri

References

• 1. Durkheim E. Suicide. Ozankaya O. (Translated by) 1. Edi, Ankara: Imge; 1992:25.
• 2. World health organization. Suicide in the world: Global health estimates 2019 [Internet]. Available at: https://www.who.int/publications-detail/suicide-in-the-world (Access Date: September 09, 2020).
• 3. Turkey statistical agency (TUIK). Basic statistics [Internet]. Available at: http://www.tuik.gov.tr/UstMenu.do?metod=temelist (Access Date: September 09, 2020).
• 4. Shah A, Bhat R, Escudero SZ, DeLeo D, Erlangsen A. Suicide rates in five-year age-bands after the age of 60 years: the international landscape. Aging Ment Health. 2016;20(2):131–8. https://doi.org/10.1080/13607863.2015.1055552
• 5. World Health Organization. Preventing suicide: a global imperative 2014 [Internet]. Available at: https://www.who.int/mental_health/suicide-prevention/world_report_2014/en/ (Access Date: September 09, 2020).
• 6. Santos J, Martins S, Azevedo LF, Fernandes L. Pain as a risk factor for suicidal behavior in older adults: a systematic review. Arch Gerontol Geriatr. 2020;87(2):104000. https://doi.org/10.1016/j.archger.2019.104000
• 7. Saraiva CB, Peixot B, Sampaio D. [Elder and suicide behavior. Suicide and self-injurious behavior: from concepts to clinical practice] (in Portuguese). First Edi, Lisbon: Lidel;2014:263–4.
• 8. Conwell Y, Duberstein PR, Cox C, Herrmann JH, Forbes NT, Caine ED. Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiatry 1996;153(8):1001–8. https://doi.org/10.1176/ajp.153.8.1001
• 9. Gokcelli DK, Tasar PT, Akcam NO, Sahin S, Akarca FK, Aktas EO, et al. Evaluation of attempted older adults’ suicides admitted to a university hospital emergency department: Izmir study. Asian J Psychiatr 2017;30(6):196–9. http://dx.doi.org/10.1016/j.ajp.2017.10.002
• 10. Yigit O, Soyuncu S, Berk Y. [Who are the suicide attempters? a view from an emergency department] (in Turkish). New Symposium J 2010;48(2):122-8.
• 11. Atli A, Uysal C, Kaya CM, Bulut M, Gunes M, Karababa IF, et al. [Assessment of admission to the emergency department due to suicide attempt: Sanliurfa sample] (in Turkish). J Mood Disord 2014;4(3):110–4. http://dx.doi.org/10.5455/jmood.20131230123128
• 12. Zhao C, Dank X, Su X, Bai J, Ma L. Epidemiology of suicide and associated socio-demographic factors in emergency department patients in 7 general hospitals in northwestern China. Med Sci Monit 2015;21:2743-9. https://doi.org/10.12659/msm.894819
• 13. De Leo D, Padoani W, Scocco P, Lie D, Bille-Brahe U, Arensman E, et al. Attempted and completed suicide in older subjects: results from the WHO/ EURO multicentre study of suicidal behaviour. Int J Geriatr Psychiatry. 2001;6(3):300–10. https://doi.org/10.1002/gps.337
• 14. Terranova C, Cardin F, Bruttocao A, Militello C. Analysis of suicide in the elderly in Italy. Risk factors and prevention of suicidal behavior. Aging Clin Exp Res 2012;24(3):20-3. https://pubmed.ncbi.nlm.nih.gov/23160501/
• 15. Kadioglu E. Assessment of suicidal cases among emergency department applicants Kutahya Evliya Çelebi Training and Research Hospital experience. Eurasian J Emerg Med. 2020;19(2):111-4. http://dx.doi.org/10.4274/eajem.galenos.2017.29484
• 16. Sevik AE, Ozcan H, Uysal E. [Analyzing suicide attempts: risk factors and follow up] (in Turkish). J Clin Psychiatry 2012;15(4):218-25.
• 17. Conejero I, Olié E, Courtet P, Calati R. Suicide in older adults: current perspectives. Clin Interv Aging. 2018;13:691–9. http://dx.doi.org/10.2147/CIA.S130670
• 18. Lim JY, Lee DH. Characteristics of drugs ingested for suicide attempts in the elderly. J Korean Med Sci. 2018;12;33(11):e86. https://doi.org/10.3346/jkms.2018.33.e86
• 19. Suominen K, Isometsä E, Lönnqvist J. Elderly suicide attempters with depression are often diagnosed only after the attempt. Int J Geriatr Psychiatry. 2004;19(1):35–40. https://doi.org/10.1002/gps.1031
• 20. Vanderhorst RK, McLaren S. Social relationships as predictors of depression and suicidal ideation in older adults. Aging Ment Health. 2005;9(6):517–25. https://doi.org/10.1002/da.22759
• 21. Juurlink DN, Pharm MMM, Kopp A, Redelmeier DA. The risk of suicide with selective serotonin reuptake inhibitors in the elderly. Am J Psychiatry. 2006; 163(5):813–21. https://doi.org/10.1176/ajp.2006.163.5.813
• 22. Makris GD, Reutfors J, Osby U, Isacsson G, Frangakis C, Ekbom A, et al. Suicide seasonality and antidepressants: a register-based study in Sweden. Acta Psychiatr Scand. 2013;127(2):117-25. https://doi.org/10.1111/j.1600-0447.2012.01891.x
• 23. Carlsten A, Waern M. Are sedatives and hypnotics associated with increased suicide risk of suicide in the elderly? BMC Geriatrics. 2009;9(20):1-6. https://doi.org/10.1186/1471-2318-9-20
• 24. FDA U.S. Food and drug administration clinical review: relationship between antidepressant drugs and suicidality in adults. [Internet]. Available at: http://www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4272b1-01 FDA.pdf (Access Date: September 09, 2020).
• 25. Conwell Y, Duberstein PR, Caine ED. Risk factors for suicide in later life. Biol. Psychiatry. 2002;52(3):193–204. https://doi.org/10.1016/s0006-3223(02)01347-1