Margda Waern et al., Mental Disorder in Elderly Suicides: a Case-Control Study.

159 AM. J. PSYCHIATRY 450 (2002).

The authors' goal was to study the importance of different psychiatric disorders in relation to suicide in individuals sixty-five years old or older. The psychological autopsy approach was used to study eighty-five cases of suicide among subjects who were sixty-five years old or older; 153 living comparison subjects from the same age group who were randomly selected from the tax register were interviewed face to face. Retrospective axis I diagnoses were made according to DSM-IV on the basis of interview data and medical records.

Ninety-seven percent of the suicide victims fulfilled criteria for at least one DSM-IV axis I diagnosis, compared with 18% of the living comparison subjects. Recurrent major depressive disorder was a very strong risk factor for suicide, as was substance use disorder. An elevated risk was also associated with minor depressive disorder, single-episode major depressive disorder, and anxiety disorder. Comorbid axis I disorders were observed in fifteen (38%) of the thirty-nine elderly subjects with major depressive disorder who had committed suicide.

Although recurrent major depressive disorder was the mental disorder most strongly associated with suicide, the findings of this study suggest that older individuals who commit suicide represent a heterogeneous group with regard to mental disorders, implying a need for differentiated prevention strategies. Most of the suicide victims in this study suffered from a depressive disorder at the time of their deaths, which is consistent with previous...