- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- 8.1 The biology of ageing
- 8.2 Sociology of normal ageing
- 8.3 The ageing population and the epidemiology of mental disorders among the elderly
- 8.4 Assessment of mental disorder in older patients
- 8.5 Special features of clinical syndromes in the elderly
- 8.5.2 Substance use disorders in older people
- 8.5.3 Schizophrenia and paranoid disorders in late life
- 8.5.4 Mood disorders in the elderly
- 8.5.5 Stress-related, anxiety, and obsessional disorders in elderly people
- 8.5.6 Personality disorders in the elderly
- 8.5.7 Suicide and deliberate self-harm in elderly people
- 8.5.8 Sex in old age
- 8.6 Special features of psychiatric treatment for the elderly
- 8.7 The planning and organization of services for older adults
- Section 9 Child and Adolescent Psychiatry
Suicide and deliberate self-harm in elderly people
- Chapter:
- Suicide and deliberate self-harm in elderly people
- Author(s):
Robin Jacoby
- DOI:
- 10.1093/med/9780199696758.003.0204
Although in some countries suicide rates in young males have risen dramatically in the last decade or so, suicide in old age is important because rates in older people, especially those over 74, are still proportionately higher in most countries of the world where reasonably reliable statistics can be obtained. For example, in 2004 in Lithuania where suicide incidence is currently the highest, the overall rate in males per 100 000 total population was 70.1, but in men over 74 the rate was 80.2. In the United States, where suicide is neither especially common nor rare, in 2002 the overall rate for males per 100 000 total population was 17.9, but 40.7 in men over 74. Rates for older women are nearly always much lower than for their male counterparts. A second reason for the importance of suicide in old age is that the proportion of older people in the population is rising worldwide. Indeed, the increase in developing countries is likely to be even greater than in developed countries. Although rates vary from year to year and birth cohort to cohort, it is highly likely that unless suicide prevention becomes a great deal more effective than at present, more and more older people will kill themselves in the coming years. As with younger people, completed suicide in old age may be seen as part of a continuum from suicidal thinking through deliberate self-harm (which does not lead to death), to completed suicide. An added component within this continuum for older people is that of ‘indirect self-destructive behaviour’, such as refusal to eat and drink or ‘turning one's face to the wall’ which is clearly intended to hasten death. Finally, although this section does not deal with euthanasia and related issues, assisted suicide in people with terminal illness such Alzheimer's disease and cancer may also be seen as part of the suicide continuum.
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- Section 1 The Subject Matter of and Approach to Psychiatry
- 1.3 Psychiatry as a worldwide public health problem
- 1.4 The history of psychiatry as a medical specialty
- 1.5 Ethics and values
- 1.6 The psychiatrist as a manager
- 1.7 Descriptive phenomenology
- 1.8 Assessment
- 1.9 Diagnosis and classification
- 1.10 From science to practice
- Section 2 The Scientific Basis of Psychiatric Aetiology
- 2.3 The contribution of neurosciences
- 2.4 The contribution of genetics
- 2.5 The contribution of psychological science
- 2.6 The contribution of social sciences
- 2.7 The contribution of epidemiology to psychiatric aetiology
- Section 3 Psychodynamic Contributions to Psychiatry
- Section 4 Clinical Syndromes of Adult Psychiatry
- 4.4 Persistent delusional symptoms and disorders
- 4.5 Mood disorders
- 4.6 Stress-related and adjustment disorders
- 4.7 Anxiety disorders
- Section 5 Psychiatry and Medicine
- Section 6 Treatment Methods in Psychiatry
- 6.2 Somatic treatments
- Section 7 Social Psychiatry and Service Provision
- Section 8 The Psychiatry of Old Age
- 8.1 The biology of ageing
- 8.2 Sociology of normal ageing
- 8.3 The ageing population and the epidemiology of mental disorders among the elderly
- 8.4 Assessment of mental disorder in older patients
- 8.5 Special features of clinical syndromes in the elderly
- 8.5.2 Substance use disorders in older people
- 8.5.3 Schizophrenia and paranoid disorders in late life
- 8.5.4 Mood disorders in the elderly
- 8.5.5 Stress-related, anxiety, and obsessional disorders in elderly people
- 8.5.6 Personality disorders in the elderly
- 8.5.7 Suicide and deliberate self-harm in elderly people
- 8.5.8 Sex in old age
- 8.6 Special features of psychiatric treatment for the elderly
- 8.7 The planning and organization of services for older adults
- Section 9 Child and Adolescent Psychiatry