title: Feeling that life is not worth living (death thoughts) among middle-aged, Australian women providing unpaid care.
abstract: OBJECTIVE
  To identify the proportion of female carers who experience death thoughts and the factors associated with these thoughts, using data from the Australian Longitudinal Study on Women's Health (ALSWH).
  
  
  METHODS
  A cross-sectional analysis of the fifth ALSWH survey was conducted. 10,528 middle-aged women provided data on caring and death thoughts, 3077 were carers and 2005 of those were included in the multivariate analysis.
  
  
  RESULTS
  7.1% of female carers had felt life was not worth living in the previous week and were classified as having experienced death thoughts, compared with 5.7% of non-carers (p=.01). Carers with death thoughts had poorer physical and mental health, higher levels of anxiety, lower levels of optimism, and reported less social support (p<.01). In a multivariate model social support, mental health, carer satisfaction, and depressive symptoms significantly predicted death thoughts. Carers with clinically significant depressive symptoms were four times more likely to experience death thoughts than those without. Carers who were satisfied with their role were 50% less likely to have experienced death thoughts than those who were dissatisfied.
  
  
  CONCLUSIONS
  A small but significant proportion of female carers experience death thoughts and may be at risk for suicide. These findings add to the growing body of evidence on suicide-related thoughts and behaviours in carers and have implications for health professionals and service providers.
authors.affiliation: Centre for Health Practice Innovation, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; Griffith Health Institute, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; Australian Institute for Suicide Research and Prevention, Griffith University, Messines Ridge Road, Mt. Gravatt, QLD 4122, Australia. Electronic address: s.odwyer@griffith.edu.au.
authors.forename: Siobhan T
authors.initials: ST
authors.lastname: O'Dwyer
authors.affiliation: Centre for Health Practice Innovation, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; Griffith Health Institute, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Moyle
authors.affiliation: School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Pachana
authors.affiliation: Centre for Health Practice Innovation, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia.
authors.forename: Billy
authors.initials: B
authors.lastname: Sung
authors.affiliation: Centre for Health Practice Innovation, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; Griffith Health Institute, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Barrett
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology; D001315:Australia; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D012944:Social Support; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Caregivers; Death thoughts; Depression; Mental health; Suicidal ideation