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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
LATE BREAKING TOPICS IN PSYCHIATRY 2012
Minerva Psichiatrica 2012 June;53(2):123-31
Preventing late life suicide. A review
Wyart M. 1, 2, Abbar M. 3, Courtet P. 4
1 INSERM U 1061, Université Montpellier 1, Montpellier, France, & CHU Caremeau, Nimes, France;
2 International Research Group for Suicide among the Elderly, Oslo, Norway;
3 CHU Caremeau, Nimes, France;
4 INSERM U 1061, Université Montpellier 1, Montpellier, France & CHRU Montpellier, Montpellier, France
Aim. Late life suicide is a major public health concern because of its very high rates and in the current context of a worldwide aging process. However, understanding suicidal behaviour remains a challenging task particularly among the elders who have been poorly studied. An expert panel has recently proposed recommendations on prevention strategies specific to the population. We conducted a review of surveys targeting suicide among the elderly and updated the expert panel’s recent findings.
Methods. We used an electronic data search via MEDLINE, Web Of Science and Cochrane Library to find studies specific to intervention for the prevention of suicide behaviour (suicide ideation, attempt and completed suicide) among people age 60 and over. The review concerned published articles up to december 2011. We use effects on suicidal behaviour as a main outcome and depression measures as a secondary outcome.
Results. Searches yielded 22 publications with all data available. They represented 14 types of programs using either a multilevel (N.=3), selective (N.=5) or indicated (N.=6) strategy. Collaborative care with primary settings in the management of depression provided the best level of evidence and significant reduction of suicidality in the elders. Studies mostly failed in reducing suicide rates of the old men. Further research should give a priority to multilevel strategies and target protective factors, use of media coverage, programs specific to old men and multidisciplinary cares. The concept of frailty may be an interesting alternative to an age-based stratification of the samples.