A Study on Factors Affecting Suicidal Tendency of the Elderly Living Alone on Care Services

  • Seo, Hwoyeon (Seoul National University Hospital Public Health Medical Service) ;
  • Sohn, Jee Hoon (Seoul National University Hospital Public Health Medical Service) ;
  • Cho, Sung Jun (Department of Psychiatry, Seoul National University Hospital) ;
  • Sung, Su Jeong (Department of Psychiatry, Hallym University Kangdong Sacred Heart Hospital) ;
  • Cho, Maeng Je (Seoul National University, College of Medicine) ;
  • Ahn, Seung Hee (JongnoGu Community Mental Health Center)
  • Received : 2018.05.11
  • Accepted : 2018.07.30
  • Published : 2018.08.31

Abstract

Objectives The high suicide rate has risen as a main concern in South Korea. Given the complexity of the mechanism resulting in complete suicide, studies targeting various populations are needed for broader understanding of its risk factors. This study aims to analyze the factors affecting the suicidal tendency in the population of the elderly living alone in Seoul depending on basic elderly-care services. Methods A total number of 415 people participated in the study. Home-visit interviews were administered by trained interviewers. Suicidal tendency was measured by the Korean version of mini international neuropsychiatric interview (K-MINI). Health-related quality of life was measured by a brief version of the World Health Organization Quality-of-life Scale (WHOQOL-BREF). Alcohol problem was assessed by the Korean version of the alcohol use disorders identification test (AUDIT-K). Among total subjects of 415 interviewees, the actual responses of 408 people were used for the final analysis. Results The result showed that the suicide risk was high in persons isolated from social support [odds ratio (OR) = 4.49], having depression (OR = 14.85), and having low quality of life (OR = 4.39). Conclusions We found that social support, depression and health-related quality of life are associated with suicidal tendency in the elderly living alone on basic services. Our evidence will contribute to suicide prevention policy for the elderly living alone on care services.

Keywords

References

  1. World Health Organization [homepage on the Internet]. Geneva: World Health Statistics Data Visualizations Dashboard 2017 [cited 2018]. Available from: http://apps.who.int/gho/data/node.sdg.3-4-viz-2?lang=en.
  2. Schulz R, Drayer RA, Rollman BL. Depression as a risk factor for non-suicide mortality in the elderly. Biol Psychiatry 2002;52:205-225. https://doi.org/10.1016/S0006-3223(02)01423-3
  3. Berglund M, Ojehagen A. The influence of alcohol drinking and alcohol use disorders on psychiatric disorders and suicidal behavior. Alcohol Clin Exp Res 1998;22:333S-345S. https://doi.org/10.1097/00000374-199810000-00010
  4. Conwell Y, Van Orden K, Caine ED. Suicide in older adults. Psychiatr Clin North Am 2011;34:451-468, ix. https://doi.org/10.1016/j.psc.2011.02.002
  5. Centers for Disease Control and Prevention. Promoting Individual, Family, and Community Connectedness to Prevent Suicidal Behavior. Atlanta, GA: Cent. Dis. Control Prev;2008. p.3-5.
  6. Schneider B, Lukaschek K, Baumert J, Meisinger C, Erazo N, Ladwig KH. Living alone, obesity, and smoking increase risk for suicide independently of depressive mood findings from the population-based MONICA/KORA Augsburg cohort study. J Affect Disord 2014;152-154:416-421. https://doi.org/10.1016/j.jad.2013.10.007
  7. Fukunaga R, Abe Y, Nakagawa Y, Koyama A, Fujise N, Ikeda M. Living alone is associated with depression among the elderly in a rural community in Japan. Psychogeriatrics 2012;12:179-185. https://doi.org/10.1111/j.1479-8301.2012.00402.x
  8. Gordon RS Jr. An operational classification of disease prevention. Public Health Rep 1983;98:107-109.
  9. Statics Korea. 2016 the Elderly Statistics. Daejeon: Statics Korea;2016.
  10. Rim CS, Jang GS, Jeong MS. A study on influential factors for the suicide ideation of the elderly living alone. Social Science Studies 2013;22:192-223.
  11. Seo IK, Lee YS. Mediated effects of depression on the relationship between social resources of the elderly living alone and their suicidal ideation-With a focus on the comparison between the elderly living alone in rural and urban areas. J Welf Aged Inst 2016;71:219-247.
  12. Yoo SW, Kim YS, Noh JS, Oh KS, Kim CH, Nam KG, et al. Validity of Korean version of the mini-international neuropsychiatric interview. Anxiety and mood 2006;2:50-55.
  13. World Health Organization [homepage on the Internet]. Geneva: WHO Quality of Life-BREF (WHOQOL-BREF) [cited 2018 Apr 10]. Available from: http://www.who.int/substance_abuse/research_tools/whoqolbref/en/.
  14. Min SK, Lee CI, Kim KI, Suh SY, Kim DK. Development of Korean version of WHO Quality of Life Scale abbreviated version (WHOQOL-BREF). J Korean Neuropyschiatr Assoc 2000;39:571-579.
  15. Babor TF, Grant M. From clinical research to secondary prevention: international collaboration in the development of the Alcohol Disorders Identification Test (AUDIT). Alcohol Health and Research World 1989;13:371-375.
  16. Lee BO, Lee CH, Lee PG, Choi MJ, Namkoong K. Development of Korean version of Alcohol Use Disorders Identification Test (AUDIT-K): its reliability and validity. J Korean Acad Addict Psychiatry 2000;4:83-92.
  17. Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997;170:205-228. https://doi.org/10.1192/bjp.170.3.205
  18. Harwood D, Hawton K, Hope T, Jacoby R. Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case-control study. Int J Geriatr Psychiatry 2001;16:155-165. https://doi.org/10.1002/1099-1166(200102)16:2<155::AID-GPS289>3.0.CO;2-0
  19. Conwell Y, Duberstein PR, Hirsch JK, Conner KR, Eberly S, Caine ED. Health status and suicide in the second half of life. Int J Geriatr Psychiatry 2010;25:371-379. https://doi.org/10.1002/gps.2348
  20. Girgus JS, Yang K, Ferri CV. The gender difference in depression: are elderly women at greater risk for depression than elderly men? Geriatrics 2017;2:35. https://doi.org/10.3390/geriatrics2040035
  21. Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci 2015;40:219-221. https://doi.org/10.1503/jpn.150205
  22. Jeon GS, Jang SN, Rhee SJ, Kawachi I, Cho SI. Gender differences in correlates of mental health among elderly Koreans. J Gerontol B Psychol Sci Soc Sci 2007;62:S323-S329. https://doi.org/10.1093/geronb/62.5.S323
  23. Lewitzka U, Spirling S, Ritter D, Smolka M, Goodday S, Bauer M, et al. Suicidal ideation vs. suicide attempts: clinical and psychosocial profiledifferences among depressed patients: a study on personality traits, psychopathological variables, and sociodemographic factors in 228 patients. J Nerv Ment Dis 2017;205:361-371. https://doi.org/10.1097/NMD.0000000000000667
  24. Nock MK, Kessler RC, Franklin JC. Risk factors for suicide ideation differ from those for the transition to suicide attempt: the importance of creativity, rigor, and urgency in suicide research. Clinical Psychology: Science and Practice 2016;23:31-34. https://doi.org/10.1111/cpsp.12133
  25. Conwell Y, Duberstein PR, Cox C, Herrmann JH, Forbes NT, Caine ED. Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiatry 1996;153:1001-1008. https://doi.org/10.1176/ajp.153.8.1001
  26. Henriksson MM, Marttunen MJ, Isometsa ET, Heikkinen ME, Aro HM, Kuoppasalmi KI, et al. Mental disorders in elderly suicide. Int Psychogeriatr 1995;7:275-286. https://doi.org/10.1017/S1041610295002031
  27. Cattell H. Suicide in the elderly. Advances in Psychiatric Treatment 2000;6:102-108. https://doi.org/10.1192/apt.6.2.102
  28. Kwon JD, Kim YJ, Um TY. Suicidal ideation among older adults who live alone with care services: a moderating effect of alcohol drinking in the relationship between previous suicidal attempts and suicidal ideation. J Welf Aged Inst 2011;51:297-320.
  29. Korea Suicide Prevention Center [homepage on the Internet]. Seoul: Suicide Rates by Gender and Age [cited 2018 Apr 30]. Available from: http://www.spckorea.or.kr/new/sub03/sub03.php#.
  30. Klonsky ED, May AM. The three-step theory (3ST): a new theory of suicide rooted in the “ideation-to-action” framework. International Journal of Cognitive Therapy 2015;8:114-129. https://doi.org/10.1521/ijct.2015.8.2.114