Suicide attempts and burden of physical illness among depressed elderly inpatients

There is little data on suicide among elderly depressed patients seeking psychiatric help. Recent studies have demonstrated that physical illness may increase this risk. We aimed to assess, retrospectively, the association between suicide and physical illness among depressed elderly psychiatric patients. All medical records of patients admitted during a 10-year period to an acute psychiatric ward, after having attempted suicide, were reviewed. Inclusion criteria were: age>65 years, diagnosis of a depressive disorder and intact cognition. The comparison group consisted of previous or subsequent admissions, closest (by date), of elderly patients, matching the inclusion criteria, but without previous record of attempting suicide, into the same ward. The cumulative illness rating scale (CIRS) score was calculated for each patient. 78 admissions of elderly depressed patients, who had attempted suicide before hospitalization, were examined. The comparison group (n=87) consisted of the subsequent admission of a similar but not suicidal pre-admission patient. The CIRS total score was significantly higher among suicidal patients (10.2 vs. 8.0; p=0.0008). Suicidal patients scored higher in the vascular and the respiratory sections of CIRS. Our results support reported findings of higher rates of illness among suicidal elderly patients. The CIRS may be considered an additional tool in assessing risk for suicide in elderly psychiatric subjects.