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Physical diseases as predictors of suicide in older adults: a nationwide, register-based cohort study

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Abstract

Purpose

The objective of the study was to examine the association between 39 physical diseases and death by suicide in older adults.

Methods

Individual-level register data on all older adults aged 65 years and over living in Denmark during 1990–2009 (N = 1,849,110) were analysed. Rate ratios were calculated for 39 physical diseases while adjusting for period, age group, conjugal status, income, physical comorbidity, and psychiatric disorders.

Results

In all, 4792 older adults aged 65+ died by suicide during the follow-up of >16 million person-years. Gastrointestinal cancer was linked to a rate ratio of 2.5 (95 % CI 1.9–3.5) in men while excess suicide risk for women with brain cancer was 3.5 (95 % CI 1.1–10.8) within three years of diagnosis. Men and women diagnosed with liver diseases within three years experienced a 2.7- (95 % CI 1.7–4.2) and 4.0- (95 % CI 2.5–6.4) fold higher risk of suicide, respectively, than those not diagnosed. Elevated risks of suicide were identified for lung cancer, gastrointestinal cancer, breast cancer, genital cancer, bladder cancer, lymph node cancer, epilepsy, cerebrovascular diseases, cataract, heart diseases, chronic obstructive pulmonary disorders (COPD), gastrointestinal disease, liver disease, arthritis, osteoporosis, prostate disorders, male genital disorders, and spinal fracture when compared to persons not diagnosed within three years.

Conclusions

Multiple physical diseases were linked to increased risks of suicide in older adults. Increased attention to suicidal ideation and risk assessment might be warranted during the diagnosis and treatment of these disorders.

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Acknowledgments

The current project was supported by the Danish Health Foundation, the EGV Foundation, Ejnar and AaseDanielsens Foundation, the Augustinus Foundation.

Conflict of interest

None.

Ethical standards

The research project has been carried out in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Furthermore, the project was approved by the Danish Data Protection Agency and the Danish National Board of Health (7-505-29-1848/1). Given the nature of the data, an informed consent from subjects was not required.

Author information

Authors and Affiliations

  1. The Research Unit, Mental Health Centre Copenhagen and Faculty of Health Sciences, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark

    Annette Erlangsen

  2. Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA

    Annette Erlangsen

  3. Institute of Regional Health Service, University of Southern Denmark, Odense, Denmark

    Elsebeth Stenager

  4. The Mental Health Research Unit, Aabenraa, Denmark

    Elsebeth Stenager

  5. Department of Psychiatry, and Office for Aging, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, NY, USA

    Yeates Conwell

Authors
  1. Annette Erlangsen
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  2. Elsebeth Stenager
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  3. Yeates Conwell
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Correspondence to Annette Erlangsen.

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Erlangsen, A., Stenager, E. & Conwell, Y. Physical diseases as predictors of suicide in older adults: a nationwide, register-based cohort study. Soc Psychiatry Psychiatr Epidemiol 50, 1427–1439 (2015). https://doi.org/10.1007/s00127-015-1051-0

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  • DOI: https://doi.org/10.1007/s00127-015-1051-0

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