[The relation between suicide and psychiatric disease in advanced age]

This report addresses the relation of suicide to mental illness in the elderly. Our investigation of this relation proceeds from the following two points of view: First we asked whether the fact that the elderly are most at risk from suicide is enhanced by their increased psychiatric morbidity. Secondly, sought to determine to what extent suicides of older mentally ill persons are definitely a result of their mental illness. The sample includes 310 suicides of psychiatric inpatients. These were investigated in the course of a multicenter study of six psychiatric State Hospitals in southern West Germany. The method of analysis involved the motives of the suicidal acts. Results demonstrate that age is an autonomous risk factor and not affected by psychiatric morbidity. Psychiatric morbidity of older persons is not sufficient to explain the suicidal act. Moreover, we found that if mental illness played a part, motives reflecting aspects of chronicity predominated motives reflecting psychopathology (i.e., being presecuted, losing one's mind) of the suicidal patients. Results are discussed with special reference to prevention and management of suicide risk factors in the elderly.