Predictors of Passive and Active Suicidal Ideation and Suicide Attempt Among Older People: A Study in Tertiary Care Settings in Thailand

• Main Authors: Booniam S, Wongpakaran T, Lerttrakarnnon P, Jiraniramai S, Kuntawong P, Wongpakaran N
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-12-01
• Series: Neuropsychiatric Disease and Treatment
• Subjects: suicide; elderly; risk; predictor
• Online Access: https://www.dovepress.com/predictors-of-passive-and-active-suicidal-ideation-and-suicide-attempt-peer-reviewed-article-NDT

Somboon Booniam,1 Tinakon Wongpakaran,1 Peerasak Lerttrakarnnon,2 Surin Jiraniramai,2 Pimolpun Kuntawong,1 Nahathai Wongpakaran1 1Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCorrespondence: Nahathai WongpakaranGeriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, T. Sriphum, A. Muang, Chiang Mai 50200, ThailandTel [phone] ext 320Fax [phone]Email [e-mail]: This study compared predictors of passive suicidal ideation (SI), active SI, and suicide attempt (SA) among elderly Thai patients in tertiary care settings.Patients and Methods: Psychiatric diagnoses and suicidality of 803 older people were assessed using the Mini-International Neuropsychiatric Interview and the Structured Clinical Interview for DSM-IV-TR. All participants completed the Montreal Cognitive Assessment, multidimensional scale of perceived social support (MSPSS), 15-item Thai geriatric depression scale (TGDS-15), 10-item perceived social scale and the Core Symptoms Index. The chi-square test, t-test and ANOVA were used for bivariate analysis of predictors of specific suicidality types. Multiple logistic regression was used to determine the predictors for each type of suicidality.Results: The patients’ mean age was 69.24 ± 6.90 years, and the majority were female (69.74%). Passive SI, active SI and SA were found among 20.42%, 3.74% and 2.37%, respectively, of the patients. Major depressive disorder (MDD) was a predictor of both passive and active SI (OR = 2.06 and 3.74, respectively). Other predictors of passive SI included hypomania (OR = 8.27) and positive score on the TGDS-15 (OR = 1.29). Predictors of active SI included agoraphobia (OR = 6.84) and hypomania (OR = 7.10). Predictors of SA included a family history of alcohol dependence (OR = 14.16), a history of depression (OR = 4.78) and agoraphobia (OR = 19.89). Surprisingly, hypertension and self-reported anxiety symptoms were protective factors for passive SI (OR = 0.51 and 0.85, respectively). Likewise, MSPSS was a protective factor for SA (OR = 0.90).Conclusion: Predictors of each type of suicidality differed. MDD was the main predictor for SI; however, agoraphobia and poor perceived social support were more pronounced among individuals with SA. Further investigation, especially in longitudinal fashion, should be warranted.Keywords: suicide, elderly, risk, predictor