HIGH-LEVELS OF HOPELESSNESS PERSIST IN GERIATRIC-PATIENTS WITH REMITTED DEPRESSION AND A HISTORY OF ATTEMPTED-SUICIDE

OBJECTIVE: To determine whether a high level of hopelessness after tre atment of a depressive episode is an indicator of a history of lifetim e suicide attempts in older people. DESIGN: Groups of suicide attempte rs, suicidal ideators, and nonsuicidal patients were compared via anal ysis of variance with respect to levels of hopelessness, depression, a nxiety, and global functioning before and after treatment of depressio n. SETTING: An outpatient research clinic providing two treatment prot ocols of late-life mood disorders. PARTICIPANTS: A total of 107 consec utive outpatients (mean age 67) with major depression who responded to treatment. MEASUREMENTS: Levels of hopelessness, severity of depressi on, anxiety, and global functioning were compared across the three gro ups at the beginning of treatment and at remission. RESULTS: After rem ission there were no differences between the three groups in depressio n severity, anxiety, and global functioning. Hopelessness remained sig nificantly higher in the attempter group than among ideators or nonsui cidal patients. CONCLUSIONS: Suicide attempts, the most important risk factor for subsequent suicide, are associated with persistent, high l evels of hopelessness following remission of depression in late-life p atients. These findings suggest that treatments designed specifically to lower hopelessness (such as cognitive, behavioral or interpersonal therapy) may be effective in reducing suicide risk.