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Clinical Characteristics in Older, Middle-Aged and Young Adults Who Present With Suicide Attempts at Psychiatric Emergency Departments: A Multisite Study
Institute of Neuroscience (SW, MW), Department of Psychiatry, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland (SW, MW), Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
Department of Clinical Neuroscience (BR), Centre for Psychiatry Research, Karolinska Institute, and Stockholm Health Care Services, Region Stockholm, Sweden.
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2022 (English)In: The American journal of geriatric psychiatry, ISSN 1064-7481, E-ISSN 1545-7214, Vol. 30, no 3, p. 342-351Article in journal (Refereed) Published
Abstract [en]

Objectives: To study age group differences in clinical characteristics in older, middle-aged and younger adults with actual suicide attempts (SA).

Design: Cross-sectional cohort study.

Setting: 3 Swedish university hospitals.

Participants: 821 persons who presented with self-harm at psychiatric emergency departments participated. Those with non-suicidal self-injury according to the Columbia Suicide Severity Rating Scale (C-SSRS) were excluded, leaving a total of 683 with an actual SA (18–44 years, n = 423; 45-64 years, n = 164; 65+, n = 96).

Measurements: Suicidal behavior was characterized with the C-SSRS and the Suicide Intent Scale (SIS); symptoms associated with suicide were rated with the Suicide Assessment Scale (SUAS). Diagnoses were set using the Mini-International Neuropsychiatric Interview. Patients self-rated their symptoms with the Karolinska Affective and Borderline Symptoms Scale (KABOSS).

Results: Older adults scored higher than the younger group on SIS total score and on the subjective subscale, but no age group differences were detected for the objective subscale. Half of the 65+ group fulfilled criteria for major depression, compared to 3-quarters in both the middle-aged and young groups. Anxiety disorders, as well as alcohol and substance use disorders were also less prevalent in the 65+ group, while serious physical illness was more common. Older adults scored lower on all symptom scales; effect sizes were large.

Conclusions: While older adults with an SA showed higher suicide intent than young adults, they had lower scores on all ratings of psychiatric symptomatology. Low ratings might interfere with clinicians’ assessments of the needs of older adults with intentional self-harm.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 30, no 3, p. 342-351
Keywords [en]
comparative study, depression, older adults, Suicide attempt
National Category
Psychiatry Geriatrics
Identifiers
URN: urn:nbn:se:umu:diva-187725DOI: 10.1016/j.jagp.2021.08.001ISI: 000761542400011PubMedID: 34470715Scopus ID: 2-s2.0-85114738201OAI: oai:DiVA.org:umu-187725DiVA, id: diva2:1595680
Funder
Region Västerbotten, ALFVLL-225251, ALFVLL-549931Region Stockholm, ALF 20120225, ALF 20150290Swedish Research Council, 2016-01590, 521-2011-299Forte, Swedish Research Council for Health, Working Life and Welfare, 147361, 2016-07097, ALFGBG-715841Available from: 2021-09-20 Created: 2021-09-20 Last updated: 2023-03-24Bibliographically approved

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Strömsten, Lotta M. J.Salander Renberg, Ellinor

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