Suicidal ideation and the choice of advance directives by elderly persons with affective disorders

The charts of 191 geriatric psychiatric inpatients with major depressive disorder or bipolar disorder were examined to determine demographic and psychiatric factors associated with the advance directive to have cardiopulmonary resuscitation (CPR) or not to have it in a life-threatening situation. Overall, 48 percent of patients wanted no CPR, 12 percent wanted CPR only, and 41 percent wanted all therapy performed. Patients with suicidal ideation (26 percent of the sample) were significantly more likely to choose not to have CPR. Sixty percent of patients with suicidal ideation chose not to have CPR. Patients with bipolar disorder and patients under age 70 were more likely to choose CPR.