Objective:
The aim of this study is to review gender differences in elderly suicide in relation to specific social aspects of the suicidal process and health care contact before death. Such information may have practical value in identifying and targeting vulnerable elderly in whom suicide may be potentially preventable.
Design:
Exploratory Retrospective study.
Materials and Methods:
Data was extracted from the records of coroner’s inquests into all unexpected deaths of persons aged 60 and over, in Cheshire over a period of 13 years 1989-2001. The Coroner’s office covers the whole county of Cheshire (1,000,000 of population). Verdicts of accidental death, misadventure and open verdicts were not included in data collection.
Results:
Men were less likely to have been known to psychiatric services (OR 0.4 95% CI 0.2-0.6) and less likely to have attempted suicide before compared to women (OR 0.5 95% CI 0.2-1). All deceased from ethnic minorities were men. There was no significant difference between women and men in relation to, physical or psychiatric morbidity, GP contact prior to suicide, intimation of intent or living alone. History of Deliberate Self Harm (DSH), psychiatric morbidity and being previously known to services were found to be significantly lower in childless female victims compared to elderly mothers and to men. Of suicide victims not known to services a surprisingly high proportion of 38% and 16% were found to have psychiatric morbidity in men and women respectively.
Conclusion:
Suicide is an important problem in the elderly, with gender playing an important part in their social behaviour. GPs have an important role to play in reducing elderly suicide with most contact with the health service in elderly suicide being with them. Specific postgraduate teaching designed to help detection and treatment of depression has been shown to reduce elderly suicide and may be of use in this situation. Widowed men and childless women should be high priorities for both GPs and identification programmes as they have a more “shrouded” passage to completed suicide.
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