title: Elderly suicide attempters with depression are often diagnosed only after the attempt.
abstract: OBJECTIVE
  No previous study has comprehensively investigated the pattern of health care contacts among elderly subjects attempting suicide. The present study compared elderly suicide attempters with younger attempters, before and after attempted suicide, in terms of health care contacts, clinical diagnoses of mental disorders, and characteristics predicting lack of treatment contact after the index attempt.
  
  
  METHODS
  All consecutive 1198 suicide attempters treated in hospital emergency rooms in Helsinki, Finland, from 15.1.1997 to 14.1.1998 were identified and divided into two age groups: (1) elderly suicide attempters aged 60 years or more (n = 81) and (2) suicide attempters aged under 60 years (n = 1117).
  
  
  RESULTS
  During the final 12 months before the attempt, the majority of elderly suicide attempters had a contact with primary health care, but their mood disorders were likely to have remained undiagnosed before the index attempt. In primary health care, only 4% had been diagnosed with a mood disorder before the attempt, but 57% after (p < 0.001). After the suicide attempt, most elderly suicide attempters were referred for aftercare, two thirds having contact with psychiatric care.
  
  
  CONCLUSIONS
  For purposes of preventing suicidal behaviour, screening for depression, plus further education on recognition, diagnosis and treatment of mood disorders among the elderly in primary health care setting are needed.
authors.affiliation: Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland. kirsi.suominen@ktl.fi
authors.forename: Kirsi
authors.initials: K
authors.lastname: Suominen
authors.forename: Erkki
authors.initials: E
authors.lastname: Isometsä
authors.forename: Jouko
authors.initials: J
authors.lastname: Lönnqvist
mesh_terms: D000359:Aftercare; D000367:Age Factors; D000368:Aged; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D012008:Recurrence; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology*