Suicide is the 11th leading cause o...

Suicide is the 11th leading cause of death in the United States and accounts for approximately 30000 deaths by means of year. Mood disorders, alcohol and substance abuse, male sex and advancing age are associated with an increased risk for suicide. Older adults are more likely to attempt suicide with a great deal of higher lethality than younger patients; thus, the ratio of complet to attempted suicides increases with age. Older adults also watch not to discuss their suicide plans beforehand. There are unique stressors in this population, including retirement, los of a lov single in kind social isolation, and an increasing carrying capacity of disability, which have been refer toed as risk factors for suicide. Studies have examined the connection between suicide risk and medical illnesses, further most studies are from uncontroll case series. Juurlink and associates evaluated the relationship between treatment of several illnesses and risk of suicide in older adults.

The trial design was a population-based case sway study of patients at least 66 years of age who lived in a Canadian province. Patients in this dispose had universal access to health care, including physic coverage, physician services, and hospital care. Suspected suicides between January 1 1992 and December 31 2000 were identified and considered for the research group. The authors focused upon 17 medical illnesses that are associated with suicide risk and matched a govern group of patients who were similar in age, sex and residential income quintile. The data from each cluster were analyzed to determine potential risk factors for suicide.

There were 1354 incidents of suicide during the thought Firearms, hanging, and self-poisoning were the in the greatest degree common methods for suicide. Many of the 17 illnesses evaluated (see accompanying table) had an increased remainings ratio (OR) for suicide, moreover the conditions with the highest OR were bipolar disorder (OR, 920) sharp pain (OR, 7.52), depression (OR, 644) and psychosis and agitation (OR, 509) Patients with multiple illnesses had a higher risk for suicide than those who had no illnesses. Those who had seven or more of the 17 illnesses had about a ninefold higher risk of suicide than those who had no illnesses. Approximately single half of the patients who complet suicide had visited a physician within single in kind week before the event.

The authors terminate that many of the used by all illnesses among older patients are independently associated with increased suicide risk. This finding is particularly authentic in older patients who have multiple illnesses. The authors add that this information can help physicians identify older adults who are at risk for suicide and explain discussions with these patients to obviate suicide in this population.

Juurlink DN et al. Medical illness and the risk of suicide in the somewhat advanced in life Arch Intern Med June 14 2004;164:1179-84

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