A multidimensional risk factor model for suicide attempts in later life

Sau Man Sandra Chan,1 Fung Kum Helen Chiu,1 Chiu Wa Linda Lam,1 Sau Man Corine Wong,1 Yeates Conwell2 1Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 2Department of Psychiatry, University of Rochester, Rochester, NY, USA Background:...

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Autores principales:	Chan SMS, Chiu FKH, Lam CWL, Wong SMC, Conwell Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/49f582da55364d099c5a20ace7c5e427
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spelling	oai:doaj.org-article:49f582da55364d099c5a20ace7c5e4272021-12-02T03:46:36ZA multidimensional risk factor model for suicide attempts in later life1178-2021https://doaj.org/article/49f582da55364d099c5a20ace7c5e4272014-09-01T00:00:00Zhttp://www.dovepress.com/a-multidimensional-risk-factor-model-for-suicide-attempts-in-later-lif-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021 Sau Man Sandra Chan,1 Fung Kum Helen Chiu,1 Chiu Wa Linda Lam,1 Sau Man Corine Wong,1 Yeates Conwell2 1Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 2Department of Psychiatry, University of Rochester, Rochester, NY, USA Background: Elderly suicide is a public health problem worldwide, and the risk factors are multidimensional. Chronic mental health problems, personality traits, stressful life events, comorbid medical conditions, social isolation, unemployment, and poverty are associated with higher risk for suicide in later life. There was a relative paucity of data on the neurobiological markers of elderly suicide. Objective: This study examines the conjoint roles of cerebrovascular risk factors (CVRFs) and other established biopsychosocial risk factors in older adults who had made a recent suicide attempt.Design: A cross-sectional, case-controlled study.Setting: A tertiary care setting in a public sector and a community setting.Subjects and methods: Cases (N=77) were nondemented Chinese adults aged ≥65 years, enrolled in a regional psychogeriatric service following a suicide attempt; comparison subjects (N=99) were community-dwelling nondemented older adults with no lifetime history of suicide. Measures of sociodemographic profile, life events, suicidal behavior, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I psychopathology, personality traits, functional status, physical health, CVRFs, and executive cognitive functions were administered. Results: Weighted sum of CVRF score was significantly higher in older women who had made a recent suicide attempt (mean: 10.56; standard deviation [SD]: 5.46) than comparison subjects (mean: 7.24; SD: 4.04) (t=3.52, P=0.001; df=99). Logistic regression showed that CVRF score (Exp[B]: 1.289, P=0.033), DSM-IV depressive disorders (current) (Exp[B]: 348, P<0.001), number of life events in the past 12 weeks (Exp[B]: 10.4; P<0.001), and being married (Exp[B]: 12.2, P<0.048) significantly increased odds for suicide attempt status in older women (Nagelkerke R2: 0.844). Association of CVRF score and suicide attempt status was not observed in older men for whom number of life events in the past 12 weeks (Exp[B]: 9.164; P<0.001), higher neuroticism (Exp[B]: 1.028; P=0.048), and impaired performance on a Modified Card Sorting Test (Exp[B]: 0.646; P=0.032) significantly increased odds for suicide attempt status in a logistic regression model (Nagelkerke R2: 0.611).Conclusion: Risk factors for cerebrovascular diseases may be associated with higher risk for attempted suicide in older women, but not in older men. Older men and women have distinct risk factor profiles that may inform targeted intervention and prevention strategies. Keywords: chronic medical illness, cognitive function, suicide, later lifeChan SMSChiu FKHLam CWLWong SMCConwell YDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2014, Iss default, Pp 1807-1817 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Chan SMS Chiu FKH Lam CWL Wong SMC Conwell Y A multidimensional risk factor model for suicide attempts in later life
description	Sau Man Sandra Chan,1 Fung Kum Helen Chiu,1 Chiu Wa Linda Lam,1 Sau Man Corine Wong,1 Yeates Conwell2 1Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 2Department of Psychiatry, University of Rochester, Rochester, NY, USA Background: Elderly suicide is a public health problem worldwide, and the risk factors are multidimensional. Chronic mental health problems, personality traits, stressful life events, comorbid medical conditions, social isolation, unemployment, and poverty are associated with higher risk for suicide in later life. There was a relative paucity of data on the neurobiological markers of elderly suicide. Objective: This study examines the conjoint roles of cerebrovascular risk factors (CVRFs) and other established biopsychosocial risk factors in older adults who had made a recent suicide attempt.Design: A cross-sectional, case-controlled study.Setting: A tertiary care setting in a public sector and a community setting.Subjects and methods: Cases (N=77) were nondemented Chinese adults aged ≥65 years, enrolled in a regional psychogeriatric service following a suicide attempt; comparison subjects (N=99) were community-dwelling nondemented older adults with no lifetime history of suicide. Measures of sociodemographic profile, life events, suicidal behavior, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I psychopathology, personality traits, functional status, physical health, CVRFs, and executive cognitive functions were administered. Results: Weighted sum of CVRF score was significantly higher in older women who had made a recent suicide attempt (mean: 10.56; standard deviation [SD]: 5.46) than comparison subjects (mean: 7.24; SD: 4.04) (t=3.52, P=0.001; df=99). Logistic regression showed that CVRF score (Exp[B]: 1.289, P=0.033), DSM-IV depressive disorders (current) (Exp[B]: 348, P<0.001), number of life events in the past 12 weeks (Exp[B]: 10.4; P<0.001), and being married (Exp[B]: 12.2, P<0.048) significantly increased odds for suicide attempt status in older women (Nagelkerke R2: 0.844). Association of CVRF score and suicide attempt status was not observed in older men for whom number of life events in the past 12 weeks (Exp[B]: 9.164; P<0.001), higher neuroticism (Exp[B]: 1.028; P=0.048), and impaired performance on a Modified Card Sorting Test (Exp[B]: 0.646; P=0.032) significantly increased odds for suicide attempt status in a logistic regression model (Nagelkerke R2: 0.611).Conclusion: Risk factors for cerebrovascular diseases may be associated with higher risk for attempted suicide in older women, but not in older men. Older men and women have distinct risk factor profiles that may inform targeted intervention and prevention strategies. Keywords: chronic medical illness, cognitive function, suicide, later life
format	article
author	Chan SMS Chiu FKH Lam CWL Wong SMC Conwell Y
author_facet	Chan SMS Chiu FKH Lam CWL Wong SMC Conwell Y
author_sort	Chan SMS
title	A multidimensional risk factor model for suicide attempts in later life
title_short	A multidimensional risk factor model for suicide attempts in later life
title_full	A multidimensional risk factor model for suicide attempts in later life
title_fullStr	A multidimensional risk factor model for suicide attempts in later life
title_full_unstemmed	A multidimensional risk factor model for suicide attempts in later life
title_sort	multidimensional risk factor model for suicide attempts in later life
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/49f582da55364d099c5a20ace7c5e427
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A multidimensional risk factor model for suicide attempts in later life

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