Elderly suicide attempters by self-poisoning in Korea

BACKGROUND: Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk factors and characteristics of an index suicide attempt of the elderly suicide attempters. METHODS: Subjects included 388 patients who were admitted to the emergency room following self-poisoning. Two age groups were defined: younger patients (aged less than 65 years) and older patients (aged over 65 years). Data including demographic factors, suicidal risk factors and information about the current suicide attempt were obtained from a retrospective chart review. RESULTS: The number of suicide attempters over the age of 65 years old was 57, and their mean age was 73.5 ± 7.5 years. The elderly patients had more underlying medical illnesses than the under-65 group (p < 0.001). Depression was the most common psychiatric diagnosis. Psychotropics were the most commonly ingested drugs in both groups, but the use of pesticides was more notable in the elderly. The elderly suicide attempters had higher risk-rating scores (p < 0.001) and lower rescue-rating scores (p = 0.014) than the under-65 group. Male-to-female ratio of the elderly group was nearly 1:1 unlike the under-65 group (p = 0.004). CONCLUSION: Elderly suicide attempters had different psychosocial stressors such as physical illness and more lethal suicide attempts. Our study suggests the need for development of specific preventive strategies and management guidelines for the elderly suicide attempters.