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Reasons for Living, Hopelessness, and Suicide Ideation Among Depressed Adults 50 Years or Older

From the Center of Excellence, Canandaigua VA Medical Center, Canandaigua, NY (PCB, PRD, KRC, YC); Department of Psychiatry, Center for the Study and Prevention of Suicide, University of Rochester School of Medicine and Dentistry (PCB, PRD, KRC, MJH, JKH, YC); Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, ON, Canada (MJH); Lawson Health Research Institute (MJH); and Department of Psychology, East Tennessee State University (JKH), TN.

Objective: Adults with mood disorders are at elevated risk for suicide. Psychological features such as hopelessness increase their risk for suicide ideation. Few studies have examined psychological constructs posited to lower risk for suicide ideation. The authors tested the hypothesis that reasons for living (RFL) are inversely related to suicide ideation.

Design: This report is a secondary analysis of cross-sectional data.

Setting: Participants were recruited from the clinical services of three teaching hospitals in Rochester, NY.

Participants: The sample consisted of 125 adults 50 years or older receiving treatment for a mood disorder.

Measurements: A diagnostic interview and measures of suicide ideation, depression, hopelessness, and RFL were included in the assessment battery. Dependent variables were presence and severity of suicide ideation. Data were analyzed using multivariate logistic and linear regressions.

Results: Patients who reported higher levels of fear of suicide were less likely to report suicide ideation. The relationships between hopelessness and both the presence and severity of suicide ideation were stronger among those who reported greater levels of responsibility to family.

Conclusions: Clinicians working with at-risk older adults are encouraged to explore their patients’ RFL. These cross-sectional findings point to the need for prospective research examining the associations among different RFL, hopelessness, and suicide ideation in depressed older adults.

Key Words: Aging • suicide ideation • reasons for living • hopelessness • depression