Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use

被引:155
作者
Bartels, SJ
Coakley, E
Oxman, TE
Constantino, G
Oslin, D
Chen, HT
Zubritsky, C
Cheal, K
Durai, UNB
Gallo, JJ
Llorente, M
Sanchez, H
机构
[1] Dartmouth Coll Sch Med, Dept Psychiat, Lebanon, NH USA
[2] John Snow Inc, Boston, MA USA
[3] Philadelphia VA Med Ctr, Philadelphia, PA USA
[4] Sunset Pk Family Hlth Ctr, Brooklyn, NY USA
[5] NYU, Sch Med, Dept Psychiat, New York, NY USA
[6] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA
[7] Brigham & Womens Hosp, Dept Psychiat, Boston, MA 02115 USA
[8] VA Chicago Hlth Care Syst, Chicago, IL USA
[9] Univ Illinois, Dept Psychiat, Chicago, IL USA
[10] Univ Penn, Dept Family Practice & Community Med, Philadelphia, PA 19104 USA
[11] Univ Miami, Sch Med, Miami VA Med Ctr, Ctr Geriatr Res Educ & Clin, Miami Beach, FL USA
关键词
D O I
10.1176/appi.ajgp.10.4.417
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
The authors identified correlates of active suicidal ideation and passive death ideation in older primary cart, patients with depression, anxiety and at-risk alcohol use. Participants included 2,240 older primary care patients (age 65+), who were identified in three mutually exclusive groups on the basis of responses to the Paykel suicide questions: No Ideation, Death Ideation, and Suicidal Ideation. Chi-square, ANOVA, and polytomous logistic regression analyses were used to identify characteristics associated with suicidal ideation. The highest amount of suicidal ideation was associated with co-occurring major depression and anxiety disorder (18%), and the lowest proportion occurred in at-risk alcohol use (3%). Asians have the highest (57%) and African Americans have the lowest (27%) proportion of suicidal or death ideation. Fewer social supports and more severe symptoms were associated with greater overall ideation. Death ideation was associated with the greatest medical comorbidity and highest service utilization. Contrary to previous report,,;, authors failed to find that active suicidal ideation was associated with increased contact,,; with healthcare providers. Accordingly, targeted assessment and preventive services should be emphasized for geriatric outpatients with co-occurring depression and anxiety social isolation, younger age, and Asian or Caucasian race.
引用
收藏
页码:417 / 427
页数:11
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