Identifying suicidal ideation among older adults in a general practice setting.
BACKGROUND
Up to 70% of older people who commit suicide consult a general practitioner (GP) in the month prior to their death. The purpose of this study was to identify the clinical and demographic characteristics of older adults who are contemplating suicide and are in contact with a GP.


METHODS
We utilised a cross-sectional study to investigate the association between suicidal ideation and clinical/demographic variables of 504 consecutive patients aged 60 years or over, attending 1 of 54 randomly selected Western Australian GPs. Prior to their medical consultation, patients completed a self-report questionnaire, which included questions about suicidal ideation (Depressive Symptom Inventory-Suicidality Subscale, DSI-SS), demographic factors, lifestyle factors, physical health and mental health, including depression (Center for Epidemiologic Studies-Depression Scale, CES-D).


RESULTS
Within our sample of older patients, 6.3% acknowledged current suicidal ideation. Multivariate analyses indicated that current suicidal ideation was strongly associated with being depressed at least occasionally during the previous week (OR=7.3, 95% CI=2.3-23.0), CES-D scores of 16 points or greater (OR=3.6, 95% CI=1.0-12.1), and a prior history of attempted suicide (OR=15.5, 95% CI=4.0-60.6).


CONCLUSIONS
Our results and conclusions are limited to suicidal ideation, and may not apply to suicidal behaviour.


CONCLUSIONS
Depressive symptomatology is strongly associated with suicidal ideation in later life. Strategies that enhance GPs' identification and treatment of affective illness in older patients should have the greatest impact on suicide rates within this age group.
Pfaff
Jon J
JJ
School of Psychiatry and Clinical Neurosciences, University of Western Australia, RPH Ainslie House-M573, Nedlands, WA 6009, Australia. jjpfaff@cyllene.uwa.edu.au
Almeida
Osvaldo P
OP
D000368:Aged; D000375:Aging / Q000523:psychology*; D003430:Cross-Sectional Studies; D003710:Demography; D003863:Depression / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D011320:Primary Health Care; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology*