Hostname: page-component-7c8c6479df-hgkh8 Total loading time: 0 Render date: 2024-03-19T05:58:20.678Z Has data issue: false hasContentIssue false

Path analysis of suicide ideation in older people

Published online by Cambridge University Press:  13 December 2013

Seolmin Kim
Affiliation:
Department of Psychiatry, Konkuk University Medical Center, Seoul, South Korea
Jee Hyun Ha*
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Seoul, South Korea
Jaehak Yu
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Seoul, South Korea
Doo-Heum Park
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Seoul, South Korea
Seung-Ho Ryu
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Seoul, South Korea
*
Correspondence should be addressed to: Jee Hyun Ha, MD, PhD, Department of Psychiatry, School of Medicine, Konkuk University, 4-12 Hwayang-dong, Gwangjin-ku, Seoul, South Korea. Phone: +82-2-2030-7569; Fax: +82-2-2030-7748. Email: jhnha@naver.com.

Abstract

Background:

Suicide among older people is one of the most rapidly emerging healthcare issues. The objective of this study was to identify the factors associated with suicide ideation in the aged population in South Korea.

Methods:

The study recruited 684 subjects older than 65 years old (males = 147, females = 537, mean age = 78.20±7.02 years), and trained interviewers performed the interviews. The study was performed as part of a community mental health suicide prevention program. The subjects’ socio-demographic data, physical health, alcohol problems, social relationships, psychological well-being, and depression severity were all considered. The Korean version of the Beck Scale for Suicide Ideation (K-BSI) was used to evaluate the intensity of suicide ideation. Correlation and hierarchical multiple regression analyses were performed to identify the factors associated with the K-BSI. The study results were tested using a path analysis.

Results:

Depression severity was positively correlated with suicide ideation, and economic status, psychological well-being, and social relationships were negatively correlated with suicide ideation. Depression severity had the largest direct impact, and economic status and social relationships had indirect impacts on suicide ideation. Psychological well-being exerted both direct and indirect influences.

Conclusion:

Depression severity was the most important predictor of suicide ideation among older people. Other direct and indirect factors played secondary roles. Effective suicide prevention strategies should focus on early detection and active intervention for depression. Socio-economic programs may also indirectly reduce suicide ideation among the aged population.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almeida, O. P. et al. (2012). Factors associated with suicidal thoughts in a large community study of older adults. British Journal of Psychiatry, 201, 466472.Google Scholar
Bae, J. N. and Cho, M. J. (2004). Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. Journal of Psychosomatic Research, 57, 297305.Google Scholar
Beck, A. T., Kovacs, M. and Weissman, A. (1979). Assessment of suicidal intention: the Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47, 343352.Google Scholar
Bisschop, M. I., Kriegsman, D. M. W., Deeg, D. J. H., Beeckman, A. T. F. and Tilburg, W. (2004). The longitudinal relation between chronic diseases and depression in older persons in the community: the Longitudinal Aging Study Amsterdam. Journal of Clinical Epidemiology, 57, 187194.CrossRefGoogle ScholarPubMed
Bostwick, J. M. and Pankratz, V. S. (2000). Affective disorders and suicide risk: a reexamination. American Journal of Psychiatry, 157, 19251932.Google Scholar
Conwell, Y., Olsen, K., Caine, E. D. and Flannery, C. (1991). Suicide in later life: psychological autopsy findings. International Psychogeriatrics, 3, 5966.Google Scholar
Conwell, Y. and Thompson, C. (2008). Suicidal behavior in elders. Psychiatric Clinics of North America, 31, 333356.Google Scholar
Conwell, Y., Van Orden, K. and Caine, E. D. (2011). Suicide in older adults. Psychiatric Clinics of North America, 34, 451468, ix.Google Scholar
De Leo, D. et al. (2002). Repetition of suicidal behaviour in elderly Europeans: a prospective longitudinal study. Journal of Affective Disorders, 72, 291295.Google Scholar
Fassberg, M. M., Ostling, S., Borjesson-Hanson, A., Skoog, I. and Waern, M. (2013). Suicidal feelings in the twilight of life: a cross-sectional population-based study of 97-year-olds. BMJ Open, 3. doi: 10.1136/bmjopen-2012-002260 Google Scholar
Gong, Y., Zhang, L., Wang, Z. and Liang, Y. (2011). Pathway analysis of risk factors for severe suicidal ideation: a survey in rural China. Canadian Journal of Public Health, 102, 472475.Google Scholar
Kim, M. S., Kim, H. W. and Cha, K. H. (2001). Analysis of construct concept of psychological wellbeing. Journal of Korean Psychology: Society and Personality, 15, 1939.Google Scholar
Kim, J. M., Shin, I. S., Yoon, J. S. and Stewart, R. (2002). Prevalence and correlates of late-life depression compared between urban and rural populations in Korea. International Journal of Geriatric Psychiatry, 17, 409415.Google Scholar
Lee, H. and Kwon, J. (2009). Validation for the Beck Scale for Suicide Ideation with Korean university students. Korean Journal of Clinical Psychology, 28, 11551172.Google Scholar
Lee, S. J. and Lee, S. H. (2009). A study of elderly suicide preventive measures. Korean Forum of Public Health and Welfare, 156, 3242.Google Scholar
Mcintosh, J. L., Santos, J. F. and Hubbard, R. W. (1994). Elder Suicide: Research, Theory, and Treatment. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Nam, J. H., Kang, M. H., Kim, C. E., Lee, J. S. and Bae, J. N. (2004). Validity of CAGE for older adults with alcohol use disorder in community. Journal of Korean Neuropsychiatry Assocication, 8, 4955.Google Scholar
Oyama, H., Fujita, M., Goto, M., Shibuya, H. and Sakashita, T. (2006). Outcomes of community-based screening for depression and suicide prevention among Japanese elders. Gerontologist, 46, 821826.Google Scholar
Rubenowitz, E., Waern, M., Wilhelmson, K. and Allebeck, P. (2001). Life events and psychosocial factors in elderly suicides: a case-control study. Psychological Medicine, 31, 11931202.Google Scholar
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57, 10691081.Google Scholar
Sheikh, V. I. and Yesavage, V. A. (1986). Geriatric Depression Scale (GDS), recent evidence and development of a shorter version. In Brink, T. L. (ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165174). New York: Haworth Press.Google Scholar
Shin, K. R., Jung, D., Jo, I. and Kang, Y. (2009). Depression among community-dwelling older adults in Korea: a predictive model of depression. Archives of Psychiatric Nursing, 23, 5057.CrossRefGoogle ScholarPubMed
Statistics Korea (2009). National Survey of Cause of Death. Daejeon: Statistics Korea.Google Scholar
Statistics Korea (2013). Cause of Death Statistics in 2012. Daejeon: Statistics Korea.Google Scholar
Szanto, K., Gildengers, A., Mulsant, B. H., Brown, G., Alexopoulos, G. S. and Reynolds, C. F., III (2002). Identification of suicidal ideation and prevention of suicidal behaviour in the elderly. Drugs & Aging, 19, 1124.CrossRefGoogle ScholarPubMed
Unutzer, J. et al. (2006). Reducing suicidal ideation in depressed older primary care patients. Journal of the American Geriatrics Society, 54, 15501556.CrossRefGoogle ScholarPubMed
Vaillant, G. E., Meyer, S. E. and Mukamal, K. and Soldz, S. (1998). Are social supports in late midlife a cause or a result of successful physical ageing? Psychological Medicine, 28, 11591168.Google Scholar
Zeppegno, P. et al. (2005). Differences in suicide behaviour in the elderly: a study in two provinces of Northern Italy. International Journal of Geriatric Psychiatry, 20, 769775.Google Scholar