Regular Research Article
Increased Risk of Attempted Suicide Among Aging Holocaust Survivors

https://doi.org/10.1097/00019442-200508000-00009Get rights and content

Objective

Suicide rates are higher in elderly persons than in those at other phase of the life-cycle. The majority of World War II (WWII) veterans and Holocaust survivors still define their war experiences as being the “most significant stressor” of their lives. Aging of survivors is frequently associated with depression, reactivation of traumatic syndromes, physical disorders, loss, and psychological distress, possibly increasing the risk of suicide. The aim of the present study was to investigate, among a large cohort of elderly Holocaust survivors, whether their WWII experiences confer an increased risk of suicidal behavior.

Methods

All medical records of elderly patients admitted to a psychiatric hospital in Israel during a 5-year period were retrospectively evaluated. Suicidal patients were compared with patients who had not attempted suicide.

Results

Of 921 eligible patients, 374 were Holocaust survivors; 135 (14.6%) had attempted suicide in the month before admission. Ninety Holocaust survivors (24%) had attempted suicide, versus 45 of the 502 patients (8.2%) with no WWII experience. The risk of attempted suicide among Holocaust survivors was significantly increased.

Conclusion

Although these findings are from a highly selected sample, we suggest that aging Holocaust survivors are at increased risk of attempting suicide. The growth of the elderly population, of whom many had had traumatic life experiences, emphasizes the need to implement preventive strategies so that suicidal risk may be contained.

Section snippets

METHODS

The Abarbanel Mental Health Center, Bat-Yam, Israel is affiliated with the Sackler School of Medicine, Tel-Aviv University. The center serves the greater Tel-Aviv area, which is demographically the “oldest” city in the country. At our center, there are 550 inpatient beds and 60 day-patients, as well as a large outpatient clinic. The psychogeriatric division is composed of three inpatient wards (120 beds), an outpatient clinic, a memory clinic, and a consultation service to nursing homes in the

RESULTS

The Abarbanel Mental Health Center serves a catchment area of approximately 680,000 subjects, of which 11.3% are 65 years of age or older. In Israel, there are presently 200,000 Holocaust survivors, including survivors who came to Israel during the wave of immigration from the former Soviet Union.14 Within our center's catchment area, 42% of the elderly citizens are Holocaust survivors, numbering approximately 28,728 subjects.9., 15.

During the study period, there were 921 admissions of elderly

DISCUSSION

The association between the Holocaust experience and suicide has rarely been studied systematically. Healthcare professionals were often taught that within the concentration camps and in the aftermath of WWII, suicide was rare, and survivors had assumed an attitude of “endurance,” thus negating the possibility of suicide. There are very few studies that documented or refuted these beliefs.16., 17., 18., 19. Camp conditions were beyond the endurance of many of the prisoners, and some of them

References (24)

  • AL Beal

    Posttraumatic stress disorder in prisoners of war and combat veterans of the Dieppe Raid: a 50-year follow-up

    Can J Psychiatry

    (1995)
  • Y Barak et al.

    Lifelong posttraumatic stress disorder: evidence from aging Holocaust survivors

    Dialogues in Clinical Neuroscience

    (2000)
  • Cited by (39)

    • Posttraumatic Stress Disorder in the Elderly

      2020, Clinics in Geriatric Medicine
      Citation Excerpt :

      In a retrospective study, elderly patients who attempted suicide admitted to an Israeli psychiatric hospital over a 5-year period were compared with admitted elderly patients without an attempt. Of the eligible patients, 24% of Holocaust survivors had attempted suicide compared with 8.2% of those who were not exposed to the conditions of World War II, suggesting a role for trauma in suicidality.9 Older male veterans surveyed regarding current suicidal ideation and past attempts revealed that combat veterans were more likely to contemplate suicide (9.2%) than noncombat veterans (4.0%).

    • Posttraumatic Stress Disorder in the Elderly

      2018, Psychiatric Clinics of North America
      Citation Excerpt :

      In a retrospective study, elderly patients who attempted suicide admitted to an Israeli psychiatric hospital over a 5-year period were compared with admitted elderly patients without an attempt. Of the eligible patients, 24% of Holocaust survivors had attempted suicide compared with 8.2% of those who were not exposed to the conditions of World War II, suggesting a role for trauma in suicidality.9 Older male veterans surveyed regarding current suicidal ideation and past attempts revealed that combat veterans were more likely to contemplate suicide (9.2%) than noncombat veterans (4.0%).

    • Lifetime suicidal attempts and current suicidal risk in aging survivors of the Jeju April 3 incident

      2018, Journal of Affective Disorders
      Citation Excerpt :

      However, the present study revealed that Jeju April 3 survivors with or without depression had higher rates of current suicide risk than did the comparison group with depression. This is consistent with the study conducted by Barak et al. (2005) showing that aging Holocaust survivors were at increased risk of attempting suicide, although the same rates of major depression were found among Holocaust survivors and control subjects. Similarly, Clarke et al. (2004) reported that depressed Holocaust survivors were 52% more likely to suffer suicidal ideation than a depressed non-Holocaust sample.

    • Stress and Suicide

      2009, Encyclopedia of Neuroscience
    • Suicidality and suicide in older people

      2009, Reviews in Clinical Gerontology
    View all citing articles on Scopus
    View full text