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Increased Risk of Attempted Suicide Among Aging Holocaust Survivors

Received December 30, 2003; revised June 8, July 14, 2004; accepted July 21, 2004. From Abarbanel Mental Health Center, Bat-Yam, Israel (YB, HS, MS, RM), Geha Mental Health Center, Petah-Tikva, Israel (DA), and the Medical Corps, IDF, Israel (HYK). All are affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Send correspondence and reprint requests to Yoram Barak, M.D., Director, Psychogeriatrics, Abarbanel Mental Health Center, 15 KKL Street, Bat-Yam, 59100, ISRAEL. e-mail: mdybarak{at}netvision.net.il
© 2005 American Association for Geriatric Psychiatry

Objective: Suicide rates are higher in elderly persons than in those at other phase of the life-cycle. The majority of World War II (WWII) veterans and Holocaust survivors still define their war experiences as being the "most significant stressor" of their lives. Aging of survivors is frequently associated with depression, reactivation of traumatic syndromes, physical disorders, loss, and psychological distress, possibly increasing the risk of suicide. The aim of the present study was to investigate, among a large cohort of elderly Holocaust survivors, whether their WWII experiences confer an increased risk of suicidal behavior. Methods: All medical records of elderly patients admitted to a psychiatric hospital in Israel during a 5-year period were retrospectively evaluated. Suicidal patients were compared with patients who had not attempted suicide. Results: Of 921 eligible patients, 374 were Holocaust survivors; 135 (14.6%) had attempted suicide in the month before admission. Ninety Holocaust survivors (24%) had attempted suicide, versus 45 of the 502 patients (8.2%) with no WWII experience. The risk of attempted suicide among Holocaust survivors was significantly increased. Conclusion: Although these findings are from a highly selected sample, we suggest that aging Holocaust survivors are at increased risk of attempting suicide. The growth of the elderly population, of whom many had had traumatic life experiences, emphasizes the need to implement preventive strategies so that suicidal risk may be contained.

Key Words: Holocaust Survivors • Suicide • Depression

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