SUICIDE IN OLDER ADULTS IN COSTA RICA DURING THE PERIOD 2010-2014
Keywords:
Elderly, suicide, legal medical record, risk factor, aging, epidemiology.Abstract
The over-65 population is a vulnerable group to committing suicide, with a risk 1.5 times higher compared to younger individuals. The aging process and the associated changes challenge the elderly, where failure to adapt predisposes to suicidal behaviors. These are more likely to be lethal in comparison to any other age group. There is few research related to the epidemiologic characteristics associated to this event. This article focuses on describing the main risk factors for suicide in the elderly by performing an epidemiologic retrospective review of all the legal medical records of the deaths declared as suicide in Costa Rica, of adults older than 65 years old, between January 1st of 2010 and December 31st of 2014. A total of 111 legal medical records were reviewed, in which most of the victims were male, retired, single, costarrican individuals. San José was the province were most cases occurred, most of them occurring on Sunday and Friday. The main death mechanisms were death by hanging and firearm suicide. From the group linked with drug abuse, benzodiazepines, opiates and benzodiazepines together with opiates were the most prevalent drug groups on the toxicology reports. Other variables, such as illness history, blood alcohol levels, previous attempt, associated stressful event and reported suicide letter were also analized.
References
2. Ribot, V., Romero, M., Ramos, M. y Gonzáles, A. (2012). Suicidio en el adulto mayor. Rev Hab Ciencias Médicas, 11, 699-708.
3. López, J. (2012). Suicidio: Problemas clínicos y médico legales. Rev Española de Medicina Legal, 34,29-30.
4. Velásquez, J. (2013). Suicidio en el anciano. Rev Colomb Psiquiat, 43, 80-84.
5. Galen, C., Chi-Leung, K., Yipb, P., et al. (2015). Predicting Suicide in older adults – a community-based cohort study in Taipei City, Taiwan. Journal of Affective Disorders, 172, 165-170.
6. Organización Mundial de la Salud. http://www.who.int/ageing/es/. Consultado el 20 de diciembre de 2015.
7. Stern, T., Fricchione, G., Cassem N., et al.. (2010). Capítulo 40, Care of suicidal patient. In Handbook of General
Hospital Psychiatry. España: Elsevier.
8. Conwell, Y., Van Order, K. & Caine, E. (2011).Suicide in older adults. Psychiatr Clin N Am, 34, 451–468.
9. Skogman, K., Alsén, M. & Öjehagen, A. (2004).Sex differences in risk factors for suicide after attempt suicide. Soc Psychiatry Psychiatr Epidemiol, 39, 113-120.
10. Ministerio de Salud de Costa Rica. (2014). Análisis de la Situación de Salud de Costa Rica. San José, CR: Dirección de Vigilancia de Salud.
11. Chaves, A., Madrigal, E., Vargas, M. y Abarca Z.(2008). El suicidio en Costa Rica en el año 2005. Medicina Legal de Costa Rica, 25, 1.
12. Quan, H., Arboleda-Florez, J., Fick, G, et al. (2002). Association between physical illness and suicide among the elderly. Soc Psychiatry Psychiatr Epidemiol, 190-97.
13. Masocco, M., Pompili, M. & Vichi M. (2008). Suicide and Marital Status in Italy. Psiquiatr Q., 275-85.
14. Lorant, V., Kunst, A. E., Huisman, M., Bopp, M. & Mackenbach, J. (2005). The EU Working Group. A European comparative study of marital status and socio-economic inequalities in suicide. Social Science and Medicine, 60, 2431–2441.
15. Roehner, B.(2015). How can one explain changes in the monthly pattern of suicide? Physica A., 424, 350-362.
16. Van Orden, K., Cukrowicz, K. C., Witte, T. K., et al. (2012). Thwarted Belongingness and Perceived Burdensomeness: Construct Validity and Psychometric Properties of Interpersonal Needs Questionnaire. NIH-PA Author manuscript, 197-215.
17. Anía, B., Chinchilla, E., Suárez, J. L., et al. (2003). Intentos de suicidio y suicidios consumados por los ancianos de una residencia. Rev Esp Geriatr Gerontol, 38 (3), 170-4.
18. Qin, P. (2005). Suicide risk in relation to level of urbanicity— a population-based linkage study. International Journal of Epidemiology, 34, 846–852.
19. Rehkopf, D. H., Dow, W. H., Rosero, L., Lin, J., Epel, E. S. & Blackburn, E. H.(2013). Longer Leukocyte Telomere
Length in Costa Rica’s Nicoya Peninsula: A Population-Based Study. Experimental Gerontology, 48 (11), 1266–1273.
20. Manthorpe, J. & Iliffe, S.(2010). Suicide in later life: public health and practitioner perspectives. Int J Geriat Psychiatry, 25(12), 1230-1238.
21. Ngamini, A., Vasiliadis, H. M. & Préville, M. (2015). Individual and area-level factors correlated with death by suicide in older adults. Preventive Medicine, 75, 44-48.
22. Innamorati, M., Pompili, M., Di Vittorio, C., et al. (2014). Suicide in the old elderly: Results from one Italian county. Am J Geriatr Psychiatry, 22 (11), 1158-67.
23. Conwell, Y. & Thompson, C. (2008). Suicidal behavior in elders. Psychiatr Clin North Am, 31(2), 333–56.
24. Draper, M. (2014). Suicidal behaviour and suicide prevention in later life. Maturitas, 79 (2), 179–183.
25. Cheung, G., Merry, S. & Sundram, F. (2015). Late-Life suicide: Insight on Motives and Contributors Derived from Suicide Notes. Journal of Affective Disorders, 185, 17–23.
26. Carsten, A. & Waern, M. (2009). Are sedatives and hypnotics associated with increased suicide risk of suicide in the elderly? BMC Geriatr, 9, 20.
27. Carlsten, A., Waern, M. & Allebeck, P. (1999). Suicides by drug poisoning among the elderly in Sweden 1969-1996. Soc Psychiatry Psychiatr Epidemiol, 609-14.
28. Kaplan, S., Huguet, N., McFarland, H., et al. (2014). Use of Alcohol Before Suicide in the United States. Annals of Epidemiology, 24(8), 588–592.
29. Zerbini, T., Ponce, J. de C., Mayumi, D., Barbosa, R., Munoz, D. R. & Leyton, V. (2012). Blood alcohol levels in suicide by hanging cases in the state of Sao Paulo, Brazil. J Forensic Leg Med, 19, 294-296.
30. Lapierre, S., Erlangsen, A., Waern, M., et al. (2011). A systematic review of elderly suicide prevention programs. Crisis, 32, 88–98.
Downloads
Published
Issue
Section
License
The intellectual property of accepted works belongs to their authors, however access to them is totally open and free, so they can be reproduced totally or partially with the only limitation of recognizing the authorship and the source of publication (Revista Medicina Legal de Costa Rica), as long as said exploitation does not have commercial character.
