FACTORS ASSOCIATED WITH SUICIDE ATTEMPTS BY DEPRESSED OLDER ADULTS - A PROSPECTIVE-STUDY

Objective: This study sought to ascertain demographic, clinical, and i nterpersonal factors prospectively associated with suicide attempts by older adults with major depressive disorder. Method: Elderly inpatien ts diagnosed as having major depressive disorder according to the Rese arch Diagnostic Criteria were administered a structured diagnostic int erview and then followed up for 1 year. Factors bearing on the interpe rsonal context of depression, including the emotional adjustment of pa tients' spouses and adult children, interpersonal strains, and relativ es' concerns related to the care of their depressed family members, we re also ascertained at the time of the patients' hospital admission. T he elderly patients who attempted suicide during the follow-up period were compared with the nonattempters across demographic, clinical, and interpersonal factors assessed during the initial interviews. Results : A suicide attempt was made by 8.7% (N=11) of the 126 elderly depress ed patients within 1 year after hospital admission. Compared with the nonattempters, the attempters were of a higher socioeconomic status, e videnced more past suicide attempts and current suicidal behavior, and constituted a disproportionately large percentage of those patients w ho had never had a remission of their index depressive episodes. Notab ly, the spouses and adult children of patients who later attempted sui cide evidenced more psychiatric symptoms, more strain in the relative- patient relationship, and more difficulties in caring for the patient than the relatives of nonattempters. Conclusions: The findings emphasi ze the need for careful attention to both clinical and interpersonal f actors in the assessment of suicide risk in the elderly.