Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T08:17:40.298Z Has data issue: false hasContentIssue false

Hopelessness and suicidal feelings among the community dwelling elderly in Dublin

Published online by Cambridge University Press:  13 June 2014

Michael Kirby
Affiliation:
Mercer's Institute for Research on Ageing, St. James's Hospital, James's St, Dublin 8, Ireland
Davis Coakley
Affiliation:
Mercer's Institute for Research on Ageing, St. James's Hospital, Dublin 8, Ireland
Alicja Radic
Affiliation:
Health Research Board, Dublin, Ireland
Brian A Lawlor
Affiliation:
Jonathon Swift Clinic and Mercer's Institute for Research on Ageing, St. James's Hospital, Dublin 8, Ireland

Abstract

Objective: The aim of this study was to determine the one-month frequency of hopelessness and suicidal feelings in a community dwelling elderly sample in Dublin.

Method: A total of 891 individuals of 65 years and over, without a dementia, were interviewed using the Geriatric Mental State (GMS)-AGECAT system. Items from the GMS relating to reports of hopelessness and suicidal feelings over the previous month were identified and the relationship of these items to gender and age was studied.

Result: Serious suicidal feelings were rare with 0.2% of the sample expressing a pervasive wish to die, but less intense feelings were more common with 15.5% reporting that life was not worth living. Hopelessness and suicidal feelings were present with similar gender frequencies unlike other studies which have demonstrated a higher frequency among females. Any feeling of hopelessness or suicidality was present in 18.4% of those aged 65-74 years (‘young elderly’) compared with 14.8% of those over 75 years (‘old elderly’). Depressed elderly who reported hopelessness or suicidal feelings were not more likely to be taking antidepressants than the depressives without such feelings.

Conclusion: Cultural factors may explain the pattern of suicidal feelings reported in our sample, with the more intense feelings being rare, and may influence the gender distribution. Hopelessness and suicidality is not more common in the ‘old elderly’ than in the ‘young elderly’ and should not be regarded as an integral part of ageing. The small number of elderly depressives with feelings of hopelessness or suicidality wh o are being treated with antidepressants is a cause for concern.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1997

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

1.Beck, AT. Depression: clinical, experimental and theoretical aspects. New York: Hoeber Medical Division, Harper and Row, 1967.Google Scholar
2.Asnis, GM, Friedman, TA, Sanderson, WCet al.Suicidal behaviours in adult psychiatric outpatients, 1: description and prevalence. Am J Psychiatry 1993; 150: 108–12.Google ScholarPubMed
3.Hawley, CJ, James, DV, Birkett, KLet al.Suicidal ideation as a presenting complaint: associated diagnosis and characteristics in a casualty population. Br J Psychiatry 1991; 159: 232–8.CrossRefGoogle Scholar
4.National Institute of Aging. Personnel for health needs of the elderly through the year 2020. Bethesda, Maryland: National Institute of Aging, 1987; 37 (NIH publication no. 87-2950).Google Scholar
5.Skoog, I, Aevarsson, O, Beskow, Jet al.Suicidal feelings in a population sample of nondemented 85 year olds. Am J Psychiatry 1996; 153: 1015–20.Google Scholar
6.Jorm, AF, Henderson, AS, Scott, Ret al.Factors associated with the wish to die in elderly people. Age Ageing 1995; 24: 389–92.CrossRefGoogle ScholarPubMed
7.Dewey, ME, Davidson, IA, Copeland, JRM. Expressed wish to die and mortality in older people: a community replication. Age Ageing 1993; 22: 109–13.CrossRefGoogle ScholarPubMed
8.Conwell, Y, Caine, ED. Rational suicide and the right to die: reality and myth. N Engl J Med 1991; 325: 1100–2.CrossRefGoogle ScholarPubMed
9.Kelleher, MJ. In: Mental disorders in older Irish people: incidence, prevalence and treatment. National Council for the Elderly Report number 45. Dublin: National Council for the Elderly, 1996.Google Scholar
10.Paykel, ES, Myers, JK, Lindenthal, JJet al.Suicidal feelings in the general population: a prevalence study. Br J Psychiatry 1974; 124: 460–9.CrossRefGoogle ScholarPubMed
11.Minkoff, K, Bergman, E, Beck, ATet al.Hopelessness, depression and attempted suicide. Am J Psychiatry 1973; 130: 455–9.CrossRefGoogle ScholarPubMed
12.Wetzel, RD. Hopelessness, depression and suicide intent. Arch Gen Psychiatry 1976; 33: 1069–73.CrossRefGoogle ScholarPubMed
13.Rifai, AH, George, CJ, Stack, JAet al.Hopelessness in suicide attempters after acute treatment of major depression in late life. Am J Psychiatry 1994; 151: 1687–90.Google ScholarPubMed
14.Baume, P, O'Malley, E. Euthanasia: attitudes and practices of medical practitioners. Med J Aust 1994; 161: 137–44.CrossRefGoogle ScholarPubMed
15.Allen-Burge, R, Storandt, M, Kinchetf, DAet al.Sex differences in the sensitivity of two self-report depression scales in older depressed inpatients. Psychology and Aging 1994; 9: 443–5.CrossRefGoogle ScholarPubMed
16.Kirby, M, Radic, A, Bruce, Iet al.Mental disorders among the community dwelling elderly. Br J Psychiatry 1997; 171: 369–72.CrossRefGoogle ScholarPubMed
17.Copeland, JRM, Kelleher, MJ, Kellett, JMet al.A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State I: development and reliability. Psychol Med 1976; 6: 439–49.CrossRefGoogle Scholar
18.Gurland, BJ, Fleiss, JL, Goldberg, Ket al.A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule II. A factor analysis. Psychol Med 1976; 6: 451–9.CrossRefGoogle Scholar
19.Wing, JK, Cooper, JE, Sartorius, N. The measurement and classification of psychiatric symptoms; an instruction manual for the PSE and Catego Program. Cambridge: Cambridge University Press, 1974.Google Scholar
20.Copeland, JRM, Dewey, ME, Wood, Met al.Range of mental illness among the elderly in the community: prevalence in Liverpool. Br J Psychiatry 1987; 150: 815–23.CrossRefGoogle ScholarPubMed
21.Henderson, AS, Duncan-Jones, P, Finlay-Jones, RA. The reliability of the Geriatric Mental State examination. Acta Psychiatr Scand 1983; 87: 19.Google Scholar
22.Copeland, JRM, Dewey, ME, Griffiths-Jones, HM. A computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychol Med 1986; 16: 8999.CrossRefGoogle ScholarPubMed
23.Johnson, EM. The Fisher-Yates exact test on unequal sample sizes. Psychometrika 1971; 37: 103–6.CrossRefGoogle Scholar
24.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (3rd ed, DSM-III). Washington DC: APA, 1980.Google Scholar
25.Copeland, JRM, Dewey, ME, Griffiths-Jones, HM. Dementia and depression in elderly persons: AGECAT compared with DSM-III and pervasive illness. Int J Geriatr Psychiatry 1990; 5: 4751.CrossRefGoogle Scholar
26.Schwab, JJ, Warheit, GJ, Holzer, CE III. Suicidal ideation and behaviour in a general population. Dis Nerv Sys 1972; 33: 745–9.Google ScholarPubMed
27.Blanchard, MR, Waterreus, A, Mann, AH. The nature of depression among older people in inner London, and the contact with primary care. Br J Psychiatry 1994; 164: 396402.CrossRefGoogle ScholarPubMed
28.Depression and suicide: are they preventable? Lancet 1992; 340: 700–1.CrossRefGoogle Scholar