In the elderly, who have higher suicide rates than any other age group, the diagnosis most frequently associated with suicidal behavior is major depression. Yet a great majority of elderly depressives do not kill themselves. The objective of this proposal is explore in elderly suicide attempters a series of factors shown in the literature and preliminary studies to be associated with late life suicidal behavior, and to determine their usefulness in distinguishing individuals with depressive illness who attempt to take their own lives from those who do not.
Specific aims are: (1) to establish those characteristics of the symptomatology and course of affective disorder in late life that are associated with attempted suicide; (2) to describe the stressful life circumstances in the year preceding entry into the study of elderly depressives with suicide attempts, and to investigate the relationship to late life suicidal behavior of two factors that have been most frequently associated with completed suicide in the elderly - physical ill health and social isolation; and to establish (3) the personality traits and (4) neuropsychological function of elderly depressed suicide attempters. In this case-control study, subjects include all patients 50 years of age and over the diagnoses of major depressive disorder admitted to the hospital following a suicide attempt (SAs). Major depressives aged 50 years and over whose admission did not follow a suicide attempt (NAs) constitute the control group. Trained raters will conduct independent interviews with both subjects and family informants, coupling objective and informant-report measures with subjective assessments of symptomatic state, physical health status, social support, and personality traits. Both cases and controls will be reassessed at discharge, 12 and 24 months after admission in order to establish the course of illness and outcome, as well as to provide ratings in the asymptomatic state that reveal state/trait characteristics of each group. The principle analyses will employ multiple logistic regression to predict categorical group membership (SA vs. NA) as a function of independent variables reflecting characteristics of the subjects' affective disorder, medical and psychiatric comorbidity, social network, personality traits, and performance on neuropsychological testing. Secondary analyses will take attempter status as the independent variable. Taking suicidality as a dimensional construct, multiple linear regression analyses will also be employed in which the above independent variables predict a continuous measure of suicidal ideation/intent.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH051201-03
Application #
2250463
Study Section
Mental Disorders of Aging Review Committee (MDA)
Project Start
1993-09-01
Project End
1998-08-31
Budget Start
1995-09-30
Budget End
1996-08-31
Support Year
3
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Rochester
Department
Psychiatry
Type
Schools of Dentistry
DUNS #
208469486
City
Rochester
State
NY
Country
United States
Zip Code
14627
Britton, Peter C; Duberstein, Paul R; Conner, Kenneth R et al. (2008) Reasons for living, hopelessness, and suicide ideation among depressed adults 50 years or older. Am J Geriatr Psychiatry 16:736-41
Holm-Denoma, Jill M; Witte, Tracy K; Gordon, Kathryn H et al. (2008) Deaths by suicide among individuals with anorexia as arbiters between competing explanations of the anorexia-suicide link. J Affect Disord 107:231-6
Dombrovski, Alexandre Y; Szanto, Katalin; Duberstein, Paul et al. (2008) Sex differences in correlates of suicide attempt lethality in late life. Am J Geriatr Psychiatry 16:905-13
Conner, Kenneth R; Duberstein, Paul R; Beckman, Anthony et al. (2007) Planning of suicide attempts among depressed inpatients ages 50 and over. J Affect Disord 97:123-8
Useda, J David; Duberstein, Paul R; Conner, Kenneth R et al. (2007) Personality differences in attempted suicide versus suicide in adults 50 years of age or older. J Consult Clin Psychol 75:126-33
Witte, Tracy K; Joiner Jr, Thomas E; Brown, Gregory K et al. (2006) Factors of suicide ideation and their relation to clinical and other indicators in older adults. J Affect Disord 94:165-72
Joiner Jr, Thomas E; Conwell, Yeates; Fitzpatrick, Kathleen Kara et al. (2005) Four studies on how past and current suicidality relate even when ""everything but the kitchen sink"" is covaried. J Abnorm Psychol 114:291-303
Talbot, Nancy L; Duberstein, Paul R; Cox, Christopher et al. (2004) Preliminary report on childhood sexual abuse, suicidal ideation, and suicide attempts among middle-aged and older depressed women. Am J Geriatr Psychiatry 12:536-8
Useda, J David; Duberstein, Paul R; Conner, Kenneth R et al. (2004) Personality and attempted suicide in depressed adults 50 years of age and older: a facet level analysis. Compr Psychiatry 45:353-61
Talbot, Nancy L; Duberstein, Paul R; Butzel, Jessica S et al. (2003) Personality traits and symptom reduction in a group treatment for women with histories of childhood sexual abuse. Compr Psychiatry 44:448-53

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