PracticeUpdate Conference Series European Congress of Psychiatry 2019

Risk Profiles Can Identify Seniors’ Likelihood for Suicidal Ideation and Attempts Depression, substance abuse, trauma-related disorders, declines in vision and psychosocial problems are among themost reliable indicators.

R isk profiles can identify older adults in care homes most likely to ideate about or attempt suicide, according to Australian research- ers who presented their results at this meeting. Identifying risk factors can be used to target inter- ventions to those who need it most, conclude the study authors. George Kuruvilla, MBBS, of Eastern Health in Melbourne, Australia and colleagues stated in their abstract that older adults disproportionately die by suicide. This is further emphasized by a statement from the Australian government in 2018 indicating that while depression affects 10% to 15% of older adults in Australia overall, the rate jumps to about

30% when looking specifically at those living in residential homes for the aged. In fact, the highest rates of suicide in men are seen in those aged 85 and older. In a cohort of older adults admitted to a mental health unit for aged persons, Dr. Kuruvilla and col- leagues investigated the unique and overlapping psychosocial risk factors associated with late-life suicide ideation and attempts. Their retrospec- tive case-control study included 135 individuals who had attempted suicide. These subjects were compared against controls on five characteristics: demographic data, clinical disorders, personality disorders, general medical conditions and psycho- social problems. Dr. Kuruvilla and his team found that, compared with controls, older suicide ideators and attempters had higher rates of depressive disorders, psycho- social problems and past suicide attempts. They also found differences between those who ideated about suicide and those who actively attempted

" …the males in this study were more likely to report suicidal ideation and women were more likely to attempt suicide. This is opposite of the patterns for all other age groups. "

MoodDisordersWithComorbidDisease LinkedWith ElevatedMortality Risk in the Elderly Early detection, better

A mong elderly people, the presence of a mood disorder and comorbid physical or mental illness may be associated with an increased 3-year mortality risk, according to research out of Taiwan. In their poster, Chun-Lin Chen, MD and Yi-Yu Pan, MD of Far Eastern Memorial Hospital in New Taipei City, Taiwan pointed out that, “there is a lack of clarity in the literature regarding the longitudi- nal risk factors associated with mortality in elderly people with mood disorders, including bipolar disorder and major depressive disorder.” Drs. Chen and Pan used the National Health Insurance Research Database in Taiwan to identify 26,570 elderly patients who were diagnosed with and treated for

mood disorders in 2008 and who were followed up for 3 consecutive years. The investigators conducted survival analyses to examine the risk factors associated with mortality over this follow-up period. Overall, 5854 patients were diagnosed with bipolar disorder and 20,716 were diagnosed with major depressive disor- der. In total, 4048 patients died within the 3-year follow-up period. This included 1003 patients with bipolar disorder and 3045 with major depressive disorder. Among these patients with mood disor- ders, the presence of comorbid dementia was associated with an approximate 40% increase in mortality risk. Other comorbid conditions associated with an increase risk of mortality were diabetes mellitus and renal disease.

control and risk prevention of physical andmental illness are important among older patients.

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