[Decreased narcissism in the aged and in suicide]

The elderly have less narcissism (= self-representation, narcissistic information, attention or libido) at their disposal to invest their own ego as well as the environment narcissistically. It therefore becomes more difficult to enlarge one's own self on encountering new persons, new environments and new customs. Some elderly may therefore feel more and more isolated and commit suicide. The rate of suicide attempts in the Canton (state) Basel-city shows a statistically significant decrease with higher age (p < 0.001) up to the age group of 60-69. Men of the age group > 80, however, manifest a significant increase in the rate of suicide attempts. The rate of fatal suicides for Swiss women increases with growing age, though not reaching statistical significance. In Basel-city, the suicide rate for women shows a rising tendency only up to the age group of 50-59 years. For Swiss men from 30-69 there is a steady, but not significant increase, which is still more pronounced from 60-69 to 70-79 (p < 0.05) and from 70-79 to > 80 (p < 0.01). For men of Basel-city the suicide rate shows, however, a clear peak in the age group 30-29 and, after a downwards trend until 40-49, an increase to a peak in the age group 60-69. From there the suicide rate stays level with a slightly decreasing trend. These statistical data seem generally to confirm, at least as a tendency, that suicide rates increase with growing age, i.e. with diminishing narcissism at one's disposal. The exception, the peak of suicides in young adults, is probably due to drug dependents who have taken their own lives. When working with elderly people, it is important to consider this reduction in narcissism and to work with them on an individual psychotherapeutic and eventually psychopharmacological but parallel also on a group basis. The individual psychotherapy should be directed toward supporting their self-confidence. In the supervision of two groups of elderlies, one of which was composed of older people who suffered from paranoid ideas, it was striking that during 75 sessions of working with this group the delusions receded and the patients became more and more communicative and no longer thought of committing suicide. In prevention it is important that the elderly be encouraged to seek participation in some group and/or family activities, though even then the individual freedom of each one not to participate in such events should be respected.