Differences between younger and older adults in the structure of suicidal intent and its correlates.
OBJECTIVE
To analyze differences in the variables associated with severity of suicidal intent and in the main factors associated with intent when comparing younger and older adults.


METHODS
Observational, descriptive cross-sectional study.


METHODS
Four general hospitals in Madrid, Spain.


METHODS
Eight hundred seventy suicide attempts by 793 subjects split into two groups: 18-54 year olds and subjects older than 55 years.


METHODS
The authors tested the factorial latent structure of suicidal intent through multigroup confirmatory factor analysis for categorical outcomes and performed statistical tests of invariance across age groups using the DIFFTEST procedure. Then, they tested a multiple indicators-multiple causes (MIMIC) model including different covariates regressed on the latent factor "intent" and performed two separate MIMIC models for younger and older adults to test for differential patterns.


RESULTS
Older adults had higher suicidal intent than younger adults (z = 2.63, p = 0.009). The final model for the whole sample showed a relationship of intent with previous attempts, support, mood disorder, personality disorder, substance-related disorder, and schizophrenia and other psychotic disorders. The model showed an adequate fit (chi²[12] = 22.23, p = 0.035; comparative fit index = 0.986; Tucker-Lewis index = 0.980; root mean square error of approximation = 0.031; weighted root mean square residual = 0.727). All covariates had significant weights in the younger group, but in the older group, only previous attempts and mood disorders were significantly related to intent severity.


CONCLUSIONS
The pattern of variables associated with suicidal intent varies with age. Recognition, and treatment of geriatric depression may be the most effective measure to prevent suicidal behavior in older adults.
Miret
Marta
M
Psychiatry Department, Autónoma University of Madrid, La Princesa University Hospital, Madrid, Spain.
Nuevo
Roberto
R
Morant
Consuelo
C
Sainz-Cortón
Enrique
E
Jiménez-Arriero
Miguel Angel
MA
López-Ibor
Juan J
JJ
Reneses
Blanca
B
Saiz-Ruiz
Jerónimo
J
Baca-García
Enrique
E
Ayuso-Mateos
José Luis
JL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015984:Causality; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology; D005163:Factor Analysis, Statistical; D006801:Humans; D033182:Intention; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D055502:Secondary Prevention; D012720:Severity of Illness Index; D012944:Social Support; D013030:Spain; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
D000928:Antidepressive Agents