title: A systematic review of physical illness, functional disability, and suicidal behaviour among older adults.
abstract: OBJECTIVE
  To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older.
  
  
  METHODS
  Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review.
  
  
  RESULTS
  Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed.
  
  
  CONCLUSIONS
  Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults.
authors.affiliation: a Department of Psychiatry and Neurochemistry , University of Gothenburg , Mölndal , Sweden.
authors.forename: Madeleine Mellqvist
authors.initials: MM
authors.lastname: Fässberg
authors.affiliation: b Department of Psychological Medicine , The University of Auckland , Auckland , New Zealand.
authors.forename: Gary
authors.initials: G
authors.lastname: Cheung
authors.affiliation: c Department of Psychology , Colorado State University , Fort Collins , CO , USA.
authors.forename: Silvia Sara
authors.initials: SS
authors.lastname: Canetto
authors.affiliation: d Research Unit , Mental Health Centre Copenhagen , Denmark.|e Department of Mental Health, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Erlangsen
authors.affiliation: f Department of Psychology , Université du Québec à Trois-Rivières , Trois-Rivières , Canada.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lapierre
authors.affiliation: g Geriatric Psychosomatics and Psychotherapy, Medical Geriatric Clinic Albertinen-Haus , University of Hamburg , Hamburg , Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Lindner
authors.affiliation: h School of Psychiatry , University of NSW , Sydney , Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.affiliation: e Department of Mental Health, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
authors.affiliation: i Samaritans of Singapore , Singapore.
authors.forename: Christine
authors.initials: C
authors.lastname: Wong
authors.affiliation: j Department of Sociology and Work Science , University of Gothenburg , Gothenburg , Sweden.
authors.forename: Jing
authors.initials: J
authors.lastname: Wu
authors.affiliation: k Department of Psychiatry and Family Medicine , University of Rochester Medical Center , Rochester , NY , USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Duberstein
authors.affiliation: l Section of Psychiatry and Neurochemistry , University of Gothenburg/Sahlgrenska University Hospital , Gothenburg , Sweden.
authors.forename: Margda
authors.initials: M
authors.lastname: Wærn
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000523:psychology* / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D012931:Social Environment; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data
keywords: death wishes; functional disability; nonfatal suicidal behaviour; physical illness; suicidal ideation; suicide