Hostname: page-component-848d4c4894-r5zm4 Total loading time: 0 Render date: 2024-06-14T20:33:23.619Z Has data issue: false hasContentIssue false

Sense of coherence in elderly suicide attempters: the impact of social and health-related factors

Published online by Cambridge University Press:  01 March 2011

Madeleine Mellqvist*
Affiliation:
Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
Stefan Wiktorsson
Affiliation:
Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
Erik Joas
Affiliation:
Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
Svante Östling
Affiliation:
Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
Ingmar Skoog
Affiliation:
Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
Margda Waern
Affiliation:
Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
*
Correspondence should be addressed to: Madeleine Mellqvist, MSc, Neuropsychiatric Epidemiology Unit, Neuropsychiatry SU/Mölndal, Wallinsgatan 6, SE 431 41 Mölndal, Sweden. Phone: +46 (0) 31 343 86 50; Fax: +46 (0) 31 776 04 03. Email: madeleine.mellqvist@neuro.gu.se.

Abstract

Background: An association between sense of coherence (SOC) and suicidal behavior has been suggested. The aim of this study was to identify factors associated with low SOC in elderly suicide attempters.

Methods: Eighty non-demented hospital-treated suicide attempters aged 70 years and older (38 men, 42 women, mean age 79.4 years) took part in an interview with a research psychologist and completed the 29-item SOC questionnaire. The interview included questions regarding social situation and health-related factors. The Comprehensive Psychopathological Rating Scale (CPRS) provided symptom ratings that were used in a diagnostic algorithm for DSM-IV major depression. The Cumulative Illness Rating Scale for Geriatrics (CIRS-G) was used to identify individuals with serious physical illness.

Results: There was a strong relationship between major depression and SOC. While we could show no relationship between severe physical illness and SOC, associations were demonstrated with social variables including too little time spent with children, too little time spent with grandchildren and having moved within the past five years. These associations remained significant in regression models adjusted for sex, age and major depression.

Conclusions: A number of social variables were independently related to SOC in elderly suicide attempters. Prospective studies are needed in order to determine whether SOC-strengthening interventions can reduce the risk of suicidal behavior in seniors.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Antonovsky, A. (1987). Unraveling The Mystery of Health: How People Manage Stress and Stay Well. San Francisco: Jossey-Bass Publishers.Google Scholar
Åsberg, M., Montgomery, S. A., Perris, C., Schalling, D. and Sedvall, G. (1978). A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica Supplementum, 271, 527.CrossRefGoogle Scholar
Carstens, J. A. and Spangenberg, J. J. (1997). Major depression: a breakdown in sense of coherence? Psychological Reports, 80, 12111220.Google Scholar
Conwell, Y., Duberstein, P. R. and Caine, E. D. (2002). Risk factors for suicide in later life. Biological Psychiatry, 52, 193204. doi:10.1016/S0006-3223(02)01347–1.CrossRefGoogle ScholarPubMed
De Leo, D., Dello Buono, M. and Dwyer, J. (2002). Suicide among the elderly: the long-term impact of a telephone support and assessment intervention in northern Italy. British Journal of Psychiatry, 181, 226229.Google Scholar
Edelstein, B. A. et al. (2009). Development and psychometric evaluation of the reasons for living – older adults scale: a suicide risk assessment inventory. Gerontologist, 49, 736745. doi: 10.1093/geront/gnp052.CrossRefGoogle Scholar
Folstein, M. F., Robins, L. N. and Helzer, J. E. (1983). The Mini-Mental State Examination. Archives of General Psychiatry, 40, 812.Google Scholar
Gibbs, L. M., Dombrovski, A. Y., Morse, J., Siegle, G. J., Houck, P. R. and Szanto, K. (2009). When the solution is part of the problem: problem solving in elderly suicide attempters. International Journal of Geriatric Psychiatry, 24, 13961404. doi: 10.1002/gps.2276.Google Scholar
Harrison, K. E. et al. (2010). Alone? Perceived social support and chronic interpersonal difficulties in suicidal elders. International Psychogeriatrics, 22, 445454. doi: 10.1017/S1041610209991463.Google Scholar
Hawton, K. and van Heeringen, K. (2009). Suicide. Lancet, 373, 13721381.CrossRefGoogle ScholarPubMed
Holmberg, S., Thelin, A. and Stiernström, E-L. (2004). Relationship of sense of coherence to other psychosocial indices. European Journal of Psychological Assessment, 20, 227236. doi: 10.1027/1015–5759.20.4.227.CrossRefGoogle Scholar
Kjølseth, I., Ekeberg, Ø. and Steihaug, S. (2009). Why do they become vulnerable when faced with the challenges of old age? Elderly people who committed suicide, described by those who knew them. International Psychogeriatrics, 21, 903912. doi: 10.1017/S1041610209990342.CrossRefGoogle Scholar
Kouvonen, A. M. et al. (2010). Sense of coherence and psychiatric morbidity: a 19-year register-based prospective study. Journal of Epidemiology and Community Health, 64, 255261. doi:10.1136/jech.2008.083352CrossRefGoogle ScholarPubMed
Langius, A., Björvell, H. and Antonovsky, A. (1992). The sense of coherence concept and its relation to personality traits in Swedish samples. Scandinavian Journal of Caring Sciences, 6, 165171.Google Scholar
Lapierre, S. et al. (in press). A systematic review of elderly suicide prevention programs. Crisis.Google Scholar
Lundman, B. et al. (2010). Sense of coherence (SOC) related to health and mortality among very old: the Umeå 85+ study. Archives of Gerontology and Geriatrics. Epublished ahead of print, doi:10.1016/j.archger.2010.01.013.Google Scholar
Mehlum, L. (1998). Suicidal ideation and sense of coherence in male conscripts. Acta Psychiatrica Scandinavica, 98, 487492.CrossRefGoogle ScholarPubMed
Miller, M. D. et al. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale.Psychiatry Research, 41, 237248.Google Scholar
Murray, C. J. L. and Lopez, A. D. (1997). Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet, 349, 14981504. doi:10.1016/S0140-6736(96)07492-2.Google Scholar
Norekvål, T. M. et al. (2010). Sense of coherence-a determinant of quality of life over time in older female acute myocardial infarction survivors. Journal of Clinical Nursing, 19, 820831. doi: 10.1111/j.1365-2702.2009.02858.x.CrossRefGoogle ScholarPubMed
Pearson, J. L. and Conwell, Y. (1995). Suicide in late life – challenges and opportunities for research: introduction. International Psychogeriatrics, 7, 131136.CrossRefGoogle ScholarPubMed
Petrie, K. and Brook, R. (1992). Sense of coherence, depression and hopelessness as correlates of reattempting suicide. British Journal of Clinical Psychology, 31, 293300.CrossRefGoogle ScholarPubMed
Sjöström, N. (2009). Sleep, Sense of Coherence and Suicidality in Suicide Attempters. Göteborg: Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry at Sahlgrenska Academy, University of Gothenburg.Google Scholar
Skoog, I., Nilsson, L., Palmertz, B., Andreasson, L-A. and Svanborg, A. (1993). A population-based study of dementia in 85-year-olds. New England Journal of Medicine, 328, 153158.Google Scholar
Skärsäter, I., Langius, A., Ågren, H., Häggström, L. and Dencker, K. (2005). Sense of coherence and social support in relation to recovery in first-episode patients with major depression: a one-year prospective study. International Journal of Mental Health Nursing, 14, 258264.Google Scholar
Useda, J. D. et al. (2007). Personality differences in attempted suicide versus suicide in adults 50 years of age or older. Journal of Consulting and Clinical Psychology, 75, 126133. doi: 10.1037/0022-006X.75.1.126.CrossRefGoogle ScholarPubMed
van Der Laan, N. C., Schimmel, A. and Heeren, T. J. (2005). The applicability and the inter-rater reliability of the Comprehensive Psychopathological Rating Scale in an elderly clinical population. International Journal of Geriatric Psychiatry, 20, 3540. doi: 10.1002/gps.1244.CrossRefGoogle Scholar
Waern, M., Rubenowitz, E. and Wilhelmson, K. (2003). Predictors of suicide in the old elderly. Gerontology, 49, 328334, doi: 10.1159/000071715.CrossRefGoogle ScholarPubMed
Wiesmann, U. and Hannich, H-J. (2008). A salutogenic view on subjective well-being in active elderly persons. Aging and Mental Health, 12, 5665. doi: 10.1080/13607860701365998.CrossRefGoogle ScholarPubMed
Wiktorsson, S., Runesson, B., Skoog, I., Östling, S. and Waern, M. (2010). Attempted suicide in the elderly: characteristics of suicide attempters (70+) and a general population comparison group. American Journal of Geriatric Psychiatry, 18, 5767.Google Scholar
Yesavage, J. A. et al. (1982–1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 3749.Google Scholar