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Attempted Suicide in Elderly Chinese Persons

A Multi-Group, Controlled Study

Received January 13, 2004; revised June 29, July 22, 2004; accepted July 23, 2004. From the Dept. of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong (JT, HFKC, SSMC), the Center for the Study and Prevention of Suicide, Univ. of Rochester Medical Center (PRD, YC), the Sau Po Centre on Ageing, Univ. of Hong Kong (IC), the Dept. of Social Work and Social Administration, Univ. of Hong Kong (IC), and the Centre for Suicide Research and Prevention, Univ. of Hong Kong (PSFY). Send correspondence and reprint requests to Dr. Joshua Tsoh, Dept. of Psychiatry, Faculty of Medicine, The Chinese Univ. of Hong Kong, N.T., Hong Kong, China. e-mail: tsohmy{at}ha.org.hk
© 2005 American Association for Geriatric Psychiatry

Objective: Attempted suicide in later life is under-researched despite its public health significance. In this study, the authors delineated the characteristics of elderly suicide attempters in a representative Chinese sample by comparing them with suicide completers and comparison subjects age 65 years or over who were randomly selected from the community. Methods: There were 224 subjects in this study: 66 suicide attempters, 67 suicide completers, and 91 comparison subjects from the community. Using a case–control design and standardized measuring instruments, authors examined the risk and protective factors associated with attempted suicide, making direct comparisons with the community-comparison subjects and suicide completers. Results: A current diagnosis of major depression was associated with a nearly 60-fold increased risk for attempted suicide, and a population attributable risk (PAR) of 67%. Other risk factors included past suicide attempts, poorer function of self-care, arthritis, and specific personality dispositions, particularly low Conscientiousness. Co-residence with children decreased risk. Although the profiles of suicide attempters and completers were similar, they could be distinguished by suicide intent, recent life events (particularly hospitalization), functional competence, religious denomination, and personality characteristics. Conclusions: A high degree of clinical vigilance and multidisciplinary collaboration are required in the management of elderly suicide attempters. The treatment of depression should form a crucial part of the prevention program. Features that distinguish suicide completers from suicide attempters may also carry implications for the secondary prevention of suicide in elderly persons.

Key Words: Suicide • Cross-Cultural Issues • Chinese Elderly

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