Depressive symptomatology as an explanation of suicidal behavior in old age

Autores/as

  • Alejandra Segura-Cardona Universidad CES
  • Maria Dorys Cardona Arango Universidad CES
  • Angela Segura-Cardona Universidad CES
  • Carlos Robledo-Marín Universidad CES
  • Diana Muñoz-Rodríguez Universidad CES
  • Emilio Salazar-Flórez Fundación Universitaria San Martín
  • Ovidio Muñoz-Arroyave Universidad CES
  • Diego Restrepo-Ochoa Universidad CES

Palabras clave:

Suicidal ideation, Aging, Depression, Suicide, Colombia

Resumen

Objective: To establish the relationship between depressive symptoms and suicidal behavior in older people residing in the urban areas of five Colombian cities. 

Methods: A quantitative and analytical study to evaluate associated factors in a survey of 2506 individuals older than 60 was carried out. Univariate, bivariate, and multivariate analysis was carried out, taking the dependent variable: suicidal behavior, and independent variables: depressive symptoms, and demographic, social, and health conditions to adjust the final model. Hypothesis tests and crude and adjusted prevalence ratios were also calculated.  

Results: Suicidal behavior was 45.8%, with the highest proportion in adults from Pereira, followed by residents in Medellín and Santa Marta. The variability of risk is explained in 51.9%: depressive symptoms, discomfort, physical inactivity, and low perception of quality of life.  

Conclusions: Suicidal behavior in older people is a multifactorial phenomenon and preventable, which requires early detection of depressive symptoms, followed by the promotion of physical activity and the subjective perception of quality of life. Therefore, public health policies are needed that promote happiness, dignify old age, and respect their rights. 

Biografía del autor/a

Maria Dorys Cardona Arango, Universidad CES

Docente

Facultad de Medicina

Citas

World Health Organization. World report on violence and health. Washington: PAHO, 2003.

World Health Organization. Preventing suicide: a global imperative. Geneva: WHO, 2014.

Pan American Health Organization. Strategic planning of human resources in health. Washington: PAHO, 2006

Harmer B, Lee S, Duong TvH, et al. Suicidal Ideation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available: https://www.ncbi.nlm.nih.gov/books/NBK565877/

Pérez SA. El suicidio, comportamiento y prevención. Rev Cubana Med Gen Integr 1999;15(2): 196-217.

Ministry of Health and Social Protection. Mental Health Bulletin: Suicidal Behavior. Bogotá, The Ministry, 2018.

Desalegn GT, Wondie M, Dereje S, Addisu A. Suicide ideation, attempt, and determinants among medical students Northwest Ethiopia: an institution-based cross-sectional study. Ann Gen Psychiatry 2020;19 (44):1-8.

Rendón-Quintero E, Rodríguez-Gómez R. Experiences of individuals with suicidal ideation and attempts]. Rev Colomb Psiquiatr. 2016;45(2):92-100.

Crosby AE, Ortega L, Melanson C. Self-directed Violence Surveillance: Uniform Definitions and Recommended Data Elements, Version 1.0. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2011.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), 5th ed. Arlington, VA: American Psychiatric Association; 2014.

World Health Organization. Live life: an implementation guide for suicide prevention in countries. Geneva: World Health Organization; 2021.

World Health Organization. Suicide worldwide: global health estimates. Geneva: World Health Organization; 2021.

Stone D, Holland K, Bartholow B, Crosby A, Davis S, Wilkins N. Preventing Suicide: A technical package of policies, programs and practices. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2017.

Montes de Oca LA and Rodríguez DAM., D. Risk and protective factors for suicide in older adults. Psychology and Health, 2019;29(2):187-94.

World Health Organization. Suicide [internet]. Available: https://www.who.int/news-room/fact-sheets/detail/suicide

Nie Y, Hu Z, Zhu T, Xu H. A Cross-Sectional Study of the Prevalence of and Risk Factors for Suicidal Ideation Among the Elderly in Nursing Homes in Hunan Province, China. Front Psychiatry. 2020;11:339.

De Leo D and Arnautovska U. Suicidal behaviour in older adults. Primary care mental health in older people: a global perspective. Switzerland: Springer; 2019:199-210.

Zeppegno P, Gattoni E, Mastrangelo M, Gramaglia C and Sarchiapone M. Psychosocial Suicide Prevention Interventions in the Elderly: A Mini-Review of the Literature. Front. Psychol. 2019;9:2713.

Banerjee D, Rai M. Social isolation in Covid-19: The impact of loneliness. International Journal of Social Psychiatry. 2020;66(6):525-527.

Echeburúa E. The many faces of suicide in the psychological clinic. Psychological Therapy, 2015;33(2):117-26.

Simon RI. Silent suicide in the elderly. Bull Am Acad Psychiatry Law. 1989;17(1):83-95.

Gramaglia C, Calati R, Zeppegno P. Rational Suicide in Late Life: A Systematic Review of the Literature. Medicina (Kaunas). 2019;29;55(10):656.

Alphs L, Brashear HR, Chappell P, Conwell Y, Dubrava S, Khin NA, Kozauer N, Hartley DM, Miller DS, Schindler RJ, Siemers ER, Stewart M, Yaffe K. Considerations for the assessment of suicidal ideation and behavior in older adults with cognitive decline and dementia. Alzheimers Dement (N Y). 2016;23;2(1):48-59.

Stone DM, Crosby AE. Suicide Prevention. Am J Lifestyle Med. 2014;8(6):404-420.

Cui R, Fiske A. New Research on Older Adult Suicide: A Reason for Hope. Clin Gerontol. 2020;43(1):1-3.

Conejero I, Olié E, Courtet P, Calati R. Suicide in older adults: current perspectives. Clin Interv Aging. 2018;13:691-699.

Hu C, Zhao D, Gong F, Zhao Y, Li J, Sun Y. Risk factors for suicidal ideation among the older people living alone in rural region of China: A path analysis. Medicine (Baltimore). 2020;99(29):e21330.

Molina II, Mora GR, Carvajal A, Marrero M and García G. Risk factors associated with suicidal behavior in older adults. Electronic Medicenter. 2020;24(1):54-67.

Ramírez YC, Flórez HM, Cardona D, Segura AM, Segura A, Muñoz DI, Lizcano D, Morales SA, Arango C, Agudelo MC. Factors associated with suicidal ideation in older adults in three cities in Colombia, 2016. Rev Colomb Psiquiatr, 2020;49(3):142-53.

Pérez SA. Suicidal risk factors in the elderly. Ciência & Saúde Coletiva, 2012;17(8):2011-16.

Calderón-Cholbi A, Mateu-Mollá J, Lacomba-Trejo L. Risk and protective factors for suicide in older people: a systematic review. Informació Psicológica 2021;121:85-105.

Khurana H, Raj A. Aging and suicide. In B. Vijaya Prasad & S. Akbar (Eds.), Handbook of research on geriatric health, treatment, and care. IGI Publishing/IGI Global 2018:409-29.

Aslan M, Hocaoglu C, Bahceci B. Description of suicide ideation among older adults and a psychological profile: a cross-sectional study in Turkey. Cien Saude Colet. 2019;24(5):1865-74.

Martínez-Hernández O. Depression in the elderly. Electronic Medical Journal, 2007;29(5):1-11

Montes de Oca V. Discrimination against old age in Mexico City: sociopolitical and legal contrasts at the national and local level. Social Perspectives 2013;15(1):47-80.

Schmutte TJ, Wilkinson ST. Suicide in Older Adults With and Without Known Mental Illness: Results From the National Violent Death Reporting System, 2003-2016. Am J Prev Med. 2020;58(4):584-590.

Velasquez JM. Suicide in the elderly Rev Colomb Psiq. 2013;42(1):80-4.

Ministry of Health and Social Protection. National Study of Health, Wellbeing and Aging (SABE). Bogotá: The Ministry, 2015.

Cerquera AM. Relationship between cognitive processes and the level of depression in older adults institutionalized in the Asilo San Antonio de Bucaramanga. Psychological Universities. 2008;7(1):71-281.

Cardona D, Segura Á, Segura A, Muñoz D, Jaramillo D, Lizcano D, Agudelo MC, Arango C, Morales S. Vulnerability index of older adults in Medellín, Barranquilla and Pasto. Biomedica. 2018;38(Sup.1):101-13.

Beck AT, A. Rush J, Shaw BF, Emery G. Cognitive therapy of depression. 19th ed. New York: The Guilford Press; 2010.

Otzen T, Manterola C. Sampling Techniques on a study population. Int. J. Morphol. 2017;35(1):227-32.

Patterson WM, Dohn HH, Bird J, Patterson GA. Evaluation of suicidal patients: the SAD PERSONS scale. Psychosomatics. 1983;24(4):343-5, 8-9.

Ministry of Health and Social Protection – Institute for Health Technology Assessment. Clinical practice guide for the prevention, diagnosis and treatment of suicidal ideation and/or behavior (adoption). Guide No.GPC 2017-60. Bogotá: The Ministry, 2017.

Radloff LS. The CES-D Scale: a self-report depression sacle for research in the general population. Applied Psychological Measurement. 199:1(3):385-401.

Rueda-Jaimes GE, L. Díaz-Martínez LA, López-Camargo MT, Campo-Arias A. Validation of an abbreviated version of the Center for Epidemiological Studies Depression Scale (CES-D) in Colombian adults. Rev Colomb Psiq. 2009;38(3):513-21.

Mann JJ, Waternaux C, Haas GL, Malone KM. Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry. 1999;156(2):181-9.

Valiente-Morejón W, Junco-Sena B, Padrón-Vega Y, Ramos-Águila Y, Rodríguez-Méndez A. Clinical-epidemiological characterization of suicide in older adults. Rev Finlay. 2018;8(2):111-21.

Silva D, Vicente B, Saldivia S, Kohn R. Suicidal behavior and psychiatric disorders in Chile. A population-based study. Rev Med Chil, 2013;141(10):1275-82.

O'Connell H, Chin AV, Cunningham C, Lawlor BA. Recent developments: suicide in older people. BMJ. 2004;329(7471):895-9.

Andrade JA, Lozano LP, Rodríguez A, Campos JA. Biopsychosocial vulnerability and suicide in Colombian older adults. Culture of care, 2016;13(1):70-89.

Bethancourt Y de la C, Bethancourt J, Moreno Y, Saavedra A. Determination of psychosocial factors that enhance suicidal behavior in adults. Rev Med Elect de Ciego de Ávila, 2015;21(1):1-7.

González RI. Results of a scale to evaluate suicidal risk in older adults at the primary level. Rev Cub Tecnol Salud, 2018;9(1):56-64.

Fachola MCH, Lucero R, Porto V, Díaz E, Paris MA. Suicide attempt and ideation in older adults in Uruguay. Ciênc saúde colet, 2015;20(6):1693-702.

Fernandez-Rodrigues V, Sanchez-Carro Y, Lagunas LN, Rico-Uribe LA, Pemau A, Diaz-Carracedo P, Diaz-Marsa M, Hervas G, de la Torre-Luque A. Risk factors for suicidal behaviour in late-life depression: A systematic review. World J Psychiatry. 2022 Jan 19;12(1):187-203.

Cardona D, Segura A, Segura Á, Garzón MO. Contextual effects associated with depression risk variability in the elderly, Antioquia, Colombia, 2012. Biomedica. 2015;35(1):73-80.

van Heeringen K. The neurobiology of suicide and suicidality. Can J Psychiatry. 2003;48(5):292-300.

Carballo JJ, Akamnonu CP, Oquendo MA. Neurobiology of suicidal behavior. An integration of biological and clinical findings. Arch Suicide Res. 2008;12(2):93-110.

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Publicado

2025-02-11 — Actualizado el 2025-07-25

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