title: Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use.
abstract: The authors identified correlates of active suicidal ideation and passive death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use. Participants included 2,240 older primary care patients (age 65+), who were identified in three mutually exclusive groups on the basis of responses to the Paykel suicide questions: No Ideation, Death Ideation, and Suicidal Ideation. Chi-square, ANOVA, and polytomous logistic regression analyses were used to identify characteristics associated with suicidal ideation. The highest amount of suicidal ideation was associated with co-occurring major depression and anxiety disorder (18%), and the lowest proportion occurred in at-risk alcohol use (3%). Asians have the highest (57%) and African Americans have the lowest (27%) proportion of suicidal or death ideation. Fewer social supports and more severe symptoms were associated with greater overall ideation. Death ideation was associated with the greatest medical comorbidity and highest service utilization. Contrary to previous reports, authors failed to find that active suicidal ideation was associated with increased contacts with healthcare providers. Accordingly, targeted assessment and preventive services should be emphasized for geriatric outpatients with co-occurring depression and anxiety, social isolation, younger age, and Asian or Caucasian race.
authors.affiliation: Department of Psychiatry, Dartmouth Medical School, Lebanon, NH 03766, USA. stephen.j.bartels@dartmouth.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bartels
authors.forename: Eugenie
authors.initials: E
authors.lastname: Coakley
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Oxman
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Constantino
authors.forename: David
authors.initials: D
authors.lastname: Oslin
authors.forename: Hongtu
authors.initials: H
authors.lastname: Chen
authors.forename: Cynthia
authors.initials: C
authors.lastname: Zubritsky
authors.forename: Karen
authors.initials: K
authors.lastname: Cheal
authors.forename: U Nalla B
authors.initials: UN
authors.lastname: Durai
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
authors.forename: Maria
authors.initials: M
authors.lastname: Llorente
authors.forename: Herman
authors.initials: H
authors.lastname: Sanchez
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data