Health status and suicide in the second half of life.
OBJECTIVE
To examine the associations of suicide in the second half of life with medical and psychiatric illness, functional limitations, and reported use of inpatient, ambulatory, and home health care services.


METHODS
A retrospective case-control design was used to compare 86 people over age 50 years who died by suicide with a comparison group of 86 living community participants that were individually matched on age, gender, race, and county of residence.


RESULTS
Suicide decedents had more Axis I diagnoses, including current mood and anxiety disorders, worse physical health status, and greater impairment in functional capacity. They were more likely to have required psychiatric treatment, medical, or surgical hospitalization in the last year, and visiting nurse or home health aide services. In a multivariate model, the presence of any active Axis I disorder and any impairment in instrumental activities of daily living (IADL) made independent contributions to suicide risk.


CONCLUSIONS
Mental illness, physical illness, and associated functional impairments represent domains of risk for suicide in this age group. In addition to individuals with psychiatric illness, those with severe or comorbid physical illness and functional disability who require inpatient and home care services should be targeted for screening and preventive interventions.
Conwell
Yeates
Y
Department of Psychiatry, School of Medicine and Dentistry, University of Rochester (UR), USA. yeates_conwell@urmc.rochester.edu
Duberstein
Paul R
PR
Hirsch
Jameson K
JK
Conner
Kenneth R
KR
Eberly
Shirley
S
Caine
Eric D
ED
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003153:Community Health Services / Q000706:statistics & numerical data; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012307:Risk Factors; D013405:Suicide / Q000523:psychology