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Suicide in Elderly Depressed Patients

Is Active vs. Passive Suicidal Ideation a Clinically Valid Distinction?

From the Mental Health Clinical Research Center for the Study of Late-Life Mood Disorders, Western Psychiatric Institute and Clinic, Pittsburgh, PA.

The authors determined differential clinical correlates of active suicidal ideation vs. passive death wish in elderly patients with recurrent major depression. Measures of lifetime suicidal behavior and ratings of suicidal ideation, hopelessness, and depression determined "ideator" status. Active and Passive Ideators as well as Non-Ideators were then compared. Sixty percent of Active Ideators endorsed disgust or self-hatred items on the Beck Depression Inventory, compared with only 25% of Passive Ideators and 20% of Non-Ideators. However, these data challenge the clinical utility of distinguishing active and passive suicidal ideation among such patients because the two groups overall appear to be more alike than different, and ideator status (passive vs. active) may change during an episode. Clinicians should therefore not be less clinically vigilant if such patients' suicidal ideation is "only" passive.

This article has been cited by other articles:

				M. J. Heisel and G. L. Flett The Development and Initial Validation of the Geriatric Suicide Ideation Scale Am J Geriatr Psychiatry, September 1, 2006; 14(9): 742 - 751. [Abstract] [Full Text] [PDF]