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Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients

Published online by Cambridge University Press:  11 February 2015

R. C. Oude Voshaar ,
D. C. van der Veen ,
N. Kapur ,
I. Hunt ,
A. Williams  and
N. A. Pachana
R. C. Oude Voshaar*
Affiliation:
Department of Psychiatry and Interdisciplinary Center of Psychopathology of Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
D. C. van der Veen
Affiliation:
Department of Psychiatry and Interdisciplinary Center of Psychopathology of Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
N. Kapur
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
I. Hunt
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
A. Williams
Affiliation:
Centre for Suicide Prevention, University of Manchester, Manchester, UK
N. A. Pachana
Affiliation:
School of Psychology, The University of Queensland, Brisbane, Australia
*
Correspondence should be addressed to: Richard C. Oude Voshaar, University Medical Center Groningen, Department of Psychiatry (CC44), Post office box 30.001, 9700 RB Groningen, the Netherlands. Phone: +31-50-3612367. Email: r.c.oude.voshaar@umcg.nl.
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Abstract

Background:

Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients.

Method:

A 15-year national clinical survey of all suicides in the UK (n = 25,128). Among the 4,481 older patients who died by suicide (≥ 60 years), 209 (4.7%) suffered from a primary anxiety disorder, and 533 (11.9%) from a comorbid anxiety disorder. Characteristics of older (n = 209) and younger (n = 773) patients with a primary anxiety disorder were compared by logistic regression adjusted for sex and living arrangement.

Results:

Compared to younger patients, older patients with a primary anxiety disorder were more often males and more often lived alone. Although 60% of older patients had a history of psychiatric admissions and 50% of deliberate self-harm, a history of self-harm, violence, and substance misuse was significantly less frequent compared to younger patients, whereas physical health problems and comorbid depressive illness were more common. Older patients were prescribed significantly more psychotropic drugs and received less psychotherapy compared to younger patients.

Conclusion:

Anxiety disorders are involved in one of every six older patients who died by suicide. Characteristics among patients who died by suicide show severe psychopathology, with a more prominent role for physical decline and social isolation compared to their younger counterparts. Moreover, treatment was less optimal in the elderly, suggesting ageism. These results shed light on the phenomenon of suicide in late-life anxiety disorder and suggest areas where prevention efforts might be focused.

Keywords

anxiety disordersagedaged80 years and overelderlysuicide
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 7: Late Life Anxiety , July 2015 , pp. 1197 - 1205
Copyright
Copyright © International Psychogeriatric Association 2015 

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