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ABSTRACT: To identify the prevalence, correlates, and one-year naturalistic course of suicidal ideation in a representative sample of elderly adults newly admitted to visiting nurse homecare.
Five hundred and thirty-nine participants (aged > or =65), newly initiating homecare for skilled nursing services, were interviewed with the Structured Clinical Interview for DSM-IV (SCID-IV) and measures of depression severity, medical comorbidity, functional status, and social support. Participants were classified as having no suicidal ideation in the past month, passive ideation, active ideation, or active ideation with poor impulse control or suicide plan.
Fifty-seven participants (10.6%) reported passive and six (1.2%) reported active suicidal ideation. Higher depression severity, greater medical comorbidity, and lower subjective social support were independently associated with the presence of any level of suicidal ideation. At one year, suicidal ideation persisted for 36.7% of those with ideation at baseline, and the incidence of suicide ideation was 5.4%
The high prevalence, persistence, and incidence of suicidal ideation in medically ill home healthcare patients underscore the relevance of this population for suicide prevention efforts. The clinical and psychosocial factors associated with suicidal ideation in this underserved, high-risk population are potentially modifiable, and thus useful targets for suicide prevention interventions.
International Journal of Geriatric Psychiatry 01/2007; 22(1):32-7. · 2.42 Impact Factor
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ABSTRACT: The objective of this study was to examine the associations between objective and subjective social support and suicidal ideation in older adults receiving home healthcare services.
Participants were randomly selected from a sample of older adults newly starting skilled nursing care from a certified home health agency in Westchester County, NY. Research interviewers assessed 522 older adults aged 65 years and older who were receiving home care services. Subjective and objective components of social support were assessed using measures of social network, social interaction patterns, instrumental support, and perceptions of social support. Suicidal ideation was assessed using items from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the Hamilton Depression Rating Scale.
In bivariate analyses, neither objectively determined size of social network nor instrumental support was associated with suicidal ideation. However, lower social interaction patterns and lower perceived social support were significantly related to suicidal ideation. After adjusting for potential confounders, only lower perceived support remained significantly associated with suicidal ideation. In post hoc analyses of the perceptions of social support scale items, satisfaction with one's relationships and feeling useful to family and friends were significantly associated with a lower likelihood of suicidal ideation in the final multivariate logistic regression model controlling for possible confounding variables.
Subjective social support is a potentially modifiable risk factor for suicide in later life. Findings suggest that the perception of social support is an important construct to examine in future longitudinal studies examining risk and protective factors for suicidal ideation and behaviors in older adults.
American Journal of Geriatric Psychiatry 10/2006; 14(9):758-66. · 3.64 Impact Factor
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ABSTRACT: Home health care patients often have several late-life risk factors for suicide and constitute a high risk group for suicidal behaviors. In this study, we examined the characteristics of 14 older adult home health care utilizers who died by suicide and four community controls who used similar services. Both groups of home health care utilizers had multiple health problems and, with one exception, all were functionally impaired. Descriptive comparison suggests that suicide decedents were more likely than their counterparts to suffer from depressed mood, suicidal ideation, prior suicide attempt(s), alcohol dependence, chronic pain, strained family relationships, lack of social support, and financial difficulties. Identifying suicide risk factors that place older adult home health care utilizers at particularly high risk for suicidal behaviors within this population will further help target suicide preventive interventions by home care providers.
Suicide and Life-Threatening Behavior 03/2006; 36(1):65-75. · 1.33 Impact Factor
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ABSTRACT: Although early detection is closely linked to survival of breast cancer, many women do not adhere to recommended screening guidelines. One of the most studied factors that contribute to women's screening behavior is their perceived risk of developing breast cancer. In this study, the authors examined contributions of general health locus of control and breast cancer-specific control to understanding perceived risk. Sixty-six healthy women with and without family histories of breast cancer participated in the study. The following were the central findings: (1) internal locus of control and breast cancer-specific control predicted perceived risk, as measured by the certainty of remaining free of breast cancer, and (2) breast cancer-specific control mediated the relationship between internal locus of control and perceived risk. Findings suggest that significant relations between health locus of control and perceived risk variables may be overlooked in the absence of situation-specific measures.
Behavioral Medicine 02/2005; 31(1):33-40. · 1.14 Impact Factor
