Self-harm in adults: a comparison between the middle-aged and the elderly
1Psychiatry Registrar, Auckland Regional Psychiatric Registrar Training Programme, Auckland.
The New Zealand Medical Journal
|February 1, 2019
Summary
Older adults who self-harm in New Zealand face higher risks of depression and suicide, necessitating targeted interventions. This study highlights crucial differences in self-harm characteristics between middle-aged and older individuals.
Area of Science:
- Public Health
- Gerontology
- Psychiatry
Background:
- New Zealand faces high suicide rates in men aged 45-49 and 85+ years.
- Anticipated rise in late-life suicides due to an aging population.
- Self-harm is a significant predictor of future suicidal behavior.
Purpose of the Study:
- Characterize middle-aged (45-64 years) and older-aged (65+ years) individuals who self-harm.
- Identify differences in self-harm characteristics between these two age groups.
Main Methods:
- Retrospective analysis of clinical data from individuals aged 45+ presenting with self-harm.
- Data collected from a New Zealand emergency department between 2010-2013.
- Inclusion of 12-month follow-up clinical information post-presentation.
Main Results:
- Older individuals were more likely to report physical illness as a stressor (p=0.001).
- Higher prevalence of depression history (p<0.0001) and diagnosis at presentation in the older group (p<0.0001).
- Older individuals exhibited greater suicidal intent (p=0.004) and significantly lower 12-month survival rates (RR=7.5).
Conclusions:
- Significant differences exist in self-harm patterns between middle-aged and older adults.
- Age-specific suicide interventions are crucial.
- Interventions should prioritize addressing physical illness and depression in older adults.
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