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Risk factors for suicidal behaviour in late-life depression:A systematic review

World Journal of Psychiatry 2022年第1期12卷 187-203页

作者： Veronica Fernandez-Rodrigues Yolanda Sanchez-Carro Luisa Natalia Lagunas Laura Alejandra Rico-Uribe Andres Pemau Patricia Diaz-Carracedo Marina Diaz-Marsa Gonzalo Hervas Alejandro de la Torre-Luque Department of Psychology Universidad Complutense de MadridMadrid 28223Spain Department of Psychiatry Universidad Autonoma de MadridMadrid 28046Spain Centre for Biomedical Research in Mental Health(CIBERSAM) Madrid 28029Spain Department of Legal Medicine Psychiatry and PathologyUniversidad Complutense de MadridMadrid 28046Spain of Psychology La Rioja International UniversityLogrono 26006Spain Institute of Psychiatry and Mental Health San Carlos Clinical HospitalMadrid 28040Spain

BACKGROUND Suicide is a leading cause of preventable death worldwide,with its peak of maximum incidence in later life.Depression often puts an individual at higher risk for suicidal behaviour.In turn,depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing.AIM To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults,and to examine the effects of depression treatment to tackle suicide behaviour in this population.METHODS A systematic review of empirical studies,published from 2000 onwards,was conducted.Suicidal behaviour was addressed considering its varying forms(i.e.,wish to die,ideation,attempt,and completed suicide).RESULTS Thirty-five papers were selected for review,comprising both clinical and epidemiological studies.Most of studies focused on suicidal ideation(60%).The studies consistently pointed out that the risk was related to depressive episode severity,psychiatric comorbidity(anxiety or substance use disorders),poorer health status,and loss of functionality.Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults.Finally,the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response.Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms.CONCLUSION To sum up,common and age-specific risk factors seem to be involved in suicide development in depressive older adults.A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.

关键词： Late-life depression Suicide behaviour Disability Chronic disease Loneliness

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