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Identification of Suicidal Ideation and Prevention of Suicidal Behaviour in the Elderly

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Abstract

In almost all industrialised countries, men aged 75 years and older have the highest suicide rate among all age groups. Although in younger age groups suicide attempts are often impulsive and communicative acts, suicide attempts in older people (defined as aged 65 years and older) are often long planned and involve high-lethality methods. These characteristics, in addition to the fact that elderly are more fragile and frequently live alone, more often lead to fatal outcome.

In later life, in both sexes, the most common diagnosis in those who attempt or complete suicide is major depression. In contrast to other age groups, comorbidity with substance abuse and personality disorders is less frequent. Physical illness plays an important role in the suicidal behaviour of the elderly: most frequently, depression and illness co-occur; less often, the physical illness or the treating medications are causally related to the depressive symptoms. However, only 2 to 4% of terminally ill elderly commit suicide. In addition to physical illness, complicated or traumatic grief, anxiety, unremitting hopelessness after recovery from a depressive episode and history of previous suicide attempts are risk factors for suicide attempts and completed suicide. During a depressive episode, elderly patients with suicidal ideation have higher levels of anxiety and, during treatment, anxiety decreases the probability of remission and recovery. As well as overt suicide attempts, indirect self-destructive behaviours, which often lead to premature death, are common, especially in residents of nursing homes, where more immediate means to commit suicide are restricted.

Although we do not have randomised trials of treatment, studies suggest that antidepressant treatment may decrease suicide risk. Prevention and treatment trials are underway to detect the effectiveness of improved treatment of depression by primary care physicians as a means of reducing the prevalence of depressive symptoms, hopelessness and suicidal ideation.

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References

  1. Pearson JL, Conwell Y. Suicide in late life: challenges and opportunities for research. Int Psychogeriatr 1995; 7(2): 131–6

    Article  PubMed  CAS  Google Scholar 

  2. Sartorius N. Recent changes in suicide rates in selected eastern European and other European countries. In: Pearson JL, Conwell Y, editors. Suicide and aging: international perspectives. New York: Springer Publishing, 1996: 169–76

    Google Scholar 

  3. Moscicki EK. Epidemiology of suicide. In: Pearson JL, Conwell Y, editors. Suicide and aging: international perspectives. New York: Springer Publishing, 1996: 3–14

    Google Scholar 

  4. Hoyert DL, Kochanek KD, Murphy SL. Deaths: final data for 1997. Natl Vital Stat Rep 1999; 47(19): 1–104

    Google Scholar 

  5. Centers for Disease Control. Suicide among older persons: United States, 1980–1992. MMWR Morb Mortal Wkly Rep 1996; 45(1): 3–6

    Google Scholar 

  6. National Center for Health Statistics. Advance report of final mortality statistics. NCHS monthly vital statistics report. Washington, DC: National Center for Health Statistics, 1992. Report no. 40 1992

    Google Scholar 

  7. Cohen D, Llorente M, Eisdorfer C. Homicide-suicide in older persons. Am J Psychiatry 1998; 155(3): 390–6

    PubMed  CAS  Google Scholar 

  8. Nordentoft M, Breum L, Munck L, et al. High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts. BMJ 1993; 306: 1137–641

    Article  Google Scholar 

  9. Stenback A. Depression and suicidal behavior in old age. In: Birren JE, Sloane RB. editors. Handbook of mental health and aging. Englewood Cliffs (NJ): Prentice-Hall, 1980: 616–52

    Google Scholar 

  10. Shneidman E. Prologue: fifty–eight years. In: Shneidman ES, editor. On the nation of suicide. San Francisco (CA): Jossey-Bass, 1969: 1–30

    Google Scholar 

  11. Wolff K. Observations on depression and suicide in the geriatric patient. In: Wolff K, editor. Patterns of self-destruction: depression and suicide. Springfield (IL): Charles C. Thomas, 1970: 33–42

    Google Scholar 

  12. Conwell Y, Duberstein PR, Cox C, et al. Age differences in behaviors leading to completed suicide. Am J Geriatr Psychiatry 1998; 6(2): 122–6

    PubMed  CAS  Google Scholar 

  13. Beck AT, Schuyler D, Herman I. Development of suicidal intent scales. In: Beck AT, Resnick HCP, Lettieri D, editors. The prediction of suicide. Bowie (PA): Charles Press, 1974: 45–56

    Google Scholar 

  14. Farberow NL. Indirect self-destructive behavior: classification and characteristics. In: Farberow NL, editor. The many faces of suicide: indirect self-destructive behavior. New York: McGraw-Hill, 1980: 15–27

    Google Scholar 

  15. Osgood NJ. Environmental factors in suicide in long-term care facilities. Suicide Life Threat Behav 1992; 22(1): 98–106

    PubMed  CAS  Google Scholar 

  16. Osgood NJ, Brant BA, Lipman A. Suicide among the elderly in long-term care facilities. New York: Greenwood, 1991

    Google Scholar 

  17. Kastenbaum R, Mishara BL. Premature death and self-injurious behavior in old age. Geriatrics 1971; 26(7): 71–81

    PubMed  CAS  Google Scholar 

  18. Gerber K, Nehemkis A, Farberow H, et al. Indirect self-destructive behavior in chronic hemodialysis patients. Suicide Life ThreatBehav 1981; 11: 31–42

    CAS  Google Scholar 

  19. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol 1979; 47: 343–52

    Article  PubMed  CAS  Google Scholar 

  20. Szanto K, Reynolds CF, Frank E, et al. Suicide in elderly depressed patients: is ‘active’ vs. ‘passive’ suicidal ideation a clinically valid distinction? Am J Geriatr Psychiatry 1996; 4(3): 197–207

    Article  Google Scholar 

  21. Hepple J, Quinton C. One hundred cases of attempted suicide in the elderly. Br J Psychiatry 1997; 171: 42–6

    Article  PubMed  CAS  Google Scholar 

  22. Nordstrom P, Asberg M, Aberg-Wistedt A, et al. Attempted suicide predicts suicide risk in mood disorders. Acta Psychiatr Scand 1995; 92(5): 345–50

    Article  PubMed  CAS  Google Scholar 

  23. Beck AT, Steer RA, Kovacs M, et al. Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation. Am J Psychiatry 1985; 142(5): 559–63

    PubMed  CAS  Google Scholar 

  24. Mann JJ, Waternaux C, Haas GL, et al. Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 1999; 156(2): 181–9

    PubMed  CAS  Google Scholar 

  25. Asberg M, Forslund K. Neurobiological aspects of suicidal behaviour. Int Rev Psychiatry 2000; 12(1): 62–74

    Article  Google Scholar 

  26. Jones JS, Stanley B, Mann JJ, et al. CSF 5-HIAA and HVA concentrations in elderly depressed patients who attempted suicide. Am J Psychiatry 1990; 147(9): 1225–7

    PubMed  CAS  Google Scholar 

  27. Mann JJ, Malone KM. Cerebrospinal fluid amines and higher-lethality suicide attempts in depressed inpatients. Biol Psychiatry 1997; 41(2): 162–71

    Article  PubMed  CAS  Google Scholar 

  28. van Heeringen C. Suicide and the social brain: the psychobiology of risk and protective factors [abstract]. 8th European Symposium on Suicide and Suicidal Behaviour. Suicide Risk and Protective Factors in the New Millennium; 2000 Sep 9; Pisa, 26

  29. Meijer OC, de Kloet ER. Corticosterone and serotonergic neurotransmission in the hippocampus: functional implications of central corticosteroid receptor diversity. Crit Rev Neurobiol 1998; 12: 1–20

    Article  PubMed  CAS  Google Scholar 

  30. Papassotiropoulos A, Hawellek B, Frahnert C, et al. The risk of acute suicidality in psychiatric inpatients increases with low plasma cholesterol. Pharmacopsychiatry 1999; 32(1): 1–4

    Article  PubMed  CAS  Google Scholar 

  31. Harris EC, Barraclough BM. Suicide as an out come for medical disorders. Medicine (Baltimore) 1994; 73(6): 281–96

    CAS  Google Scholar 

  32. Duggan CF, Sham P, Lee AS, et al. Can future suicidal behaviour in depressed patients be predicted? J Affect Disord 1991; 22(3): 111–8

    Article  PubMed  CAS  Google Scholar 

  33. Conwell Y, Lyness JM, Duberstein P, et al. Completed suicide among older patients in primary care practices: a controlled study. J Am Geriatr Soc 2000; 48(1): 23–9

    PubMed  CAS  Google Scholar 

  34. Robins E, Murphy GE, Wilkinson RH, et al. Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides. Am J Pub Health 1959; 49: 888–9

    Article  PubMed  CAS  Google Scholar 

  35. Foley KM. The relationship of pain and symptom management to patient requests for physician-assisted suicide. J Pain Symptom Manage 1991; 6(5): 289–97

    Article  PubMed  CAS  Google Scholar 

  36. Hendin H. Suicide, assisted suicide, and euthanasia. In: Jacobs DG, editor. The Harvard Medical School guide to suicide assessment and intervention. San Francisco (CA): Jossey-Bass Inc, 1999: 540–60

    Google Scholar 

  37. Kelly B, Raphael B, Judd F, et al. Suicidal ideation, suicide attempts, and HIV infection. Psychosomatics 1998; 39(5): 405–15

    Article  PubMed  CAS  Google Scholar 

  38. Mulsant BH, Ganguli M. Epidemiology and diagnosis of depression in late-life. J Clin Psychiatry 1999; 60Suppl. 20: 9–15

    PubMed  Google Scholar 

  39. Takahashi Y, Hirasawa H, Koyama K, et al. Suicide and aging in Japan: an examination of treated elderly suicide attempters. Int Psychogeriatr 1995; 7(2): 239–51

    Article  PubMed  CAS  Google Scholar 

  40. Bostwick JM, Pankratz VS. Affective disorders and suicide risk: a re-examination. Am J Psychiatry 2000; 157(12): 1925–32

    Article  PubMed  CAS  Google Scholar 

  41. Frierson RL. Suicide attempts by the old and the very old. Arch Intern Med 1991; 151(1): 141–4

    Article  PubMed  CAS  Google Scholar 

  42. Dorpat TL, Ripley HS. A study of suicide in the Seattle area. Compr Psychiatry 1960; 1: 349–59

    Article  PubMed  CAS  Google Scholar 

  43. Conwell Y, Duberstein PR, Cox C, et al. Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiatry 1996; 153(8): 1001–8

    PubMed  CAS  Google Scholar 

  44. Conwell Y. Suicide in elderly patients. In: Schneider LS, Reynolds CF, Lebowitz BD, editors. Diagnosis and treatment of depression in late life. Washington, DC: American Psychiatric Press Inc., 1994: 397–418

    Google Scholar 

  45. Uncapher H, Gallagher-Thompson D, Osgood NJ, et al. Hopelessness and suicidal ideation in older adults. Gerontologist 1998; 38(1): 62–70

    Article  PubMed  CAS  Google Scholar 

  46. Rifai AH, George CJ, Stack JA, et al. Hopelessness continues to distinguish suicide attempters after acute treatment of major depression in later-life. Am J Psychiatry 1994; 151(11): 1687–90

    PubMed  CAS  Google Scholar 

  47. Szanto K, Reynolds CF, Conwell Y, et al. High levels of hopelessness persist in geriatric patients with remitted depression and a history of suicide attempt. J Am Geriatr Soc 1998; 46: 1401–6

    PubMed  CAS  Google Scholar 

  48. Pearson JL, Brown GK. Suicide prevention in late-life: directions for science and practice. Clin Psychol Rev 2000; 20(6): 685–705

    Article  PubMed  CAS  Google Scholar 

  49. Murphy GE, Wetzel RD, Robins E, et al. Multiple risk factors predict suicide in alcoholism. Arch Gen Psychiatry 1992; 49: 459–63

    Article  PubMed  CAS  Google Scholar 

  50. Duberstein PR, Conwell Y, Caine ED. Interpersonal stressors, substance abuse, and suicide. J Nerv Ment Dis 1993; 181: 80–5

    Article  PubMed  CAS  Google Scholar 

  51. Heikkinen ME, Aro HM, Henriksson MM, et al. Differences in recent life events between alcoholic and depressive nonalcoholic suicides. Alcohol Clin Exp Res 1994; 18: 1143–9

    Article  PubMed  CAS  Google Scholar 

  52. Fawcett J. Predictors of early suicide: identification and appropriate intervention. J Clin Psychiatry 1988; 49 Suppl.: 7–8

    PubMed  Google Scholar 

  53. Fawcett J, Scheftner WA, Fogg L, et al. Time-related predictors of suicide in major affective disorder. Am J Psychiatry 1990; 147(9): 1189–94

    PubMed  CAS  Google Scholar 

  54. Warshaw MG, Dolan RT, Keller MB. Suicidal behavior in patients with current or past-panic disorder: five years of prospective data froms the Harvard/Brown anxiety research program. Am J Psychiatry 2000; 157(11): 1876–8

    Article  PubMed  CAS  Google Scholar 

  55. Szanto K, Mulsant BH, Houck PR, et al. Treatment outcome in suicidal versus non-suicidal elderly. Am J Geriatr Psychiatry 2001; 9(3): 261–8

    PubMed  CAS  Google Scholar 

  56. Zisook S, Lyons LE. Bereavement and unresolved grief in psychiatric outpatients. Omega J Death Dying 1989; 20(4): 307–22

    Article  Google Scholar 

  57. MacMahon B, Pugh TF. Suicide in the widowed. Am J Epidemiol 1985; 81: 23–31

    Google Scholar 

  58. Szanto K, Prigerson HG, Houck PR, et al. Suicidal ideation in elderly bereaved: the role of complicated grief. Suicide Life Threat Behav 1997; 27(2): 194–207

    PubMed  CAS  Google Scholar 

  59. Sainsbury P. Suicide in London. London: Chapman & Hall, 1955

    Google Scholar 

  60. Barraclough BM. Suicide in the elderly. Br J Psychiatry 1971; 6 (Spec. Suppl.): 87–97

    Google Scholar 

  61. Conwell Y, Rotenberg M, Caine ED. Completed suicide at age 50 and over. J Am Geriatr Soc 1990; 38: 640–4

    PubMed  CAS  Google Scholar 

  62. Carney SS, Rich CL, Burke PA, et al. Suicide over 60: the San Diego study. J Am Geriatr Soc 1994; 42(2): 174–80

    PubMed  CAS  Google Scholar 

  63. De Leo D, Carollo G, Dello Buono M. Lower suicide rates associated with a Tele-Help/Tele-Check service for the elderly at home. Am J Psychiatry 1995; 152(4): 632–4

    PubMed  Google Scholar 

  64. Brown GK, Bruce ML, Pearson JL, PROSPECT Study Group. High risk management guidelines for elderly suicidal patients in primary care settings. Int J Geriatr Psychiatry 2001; 16(6): 593–601

    Article  PubMed  CAS  Google Scholar 

  65. Kroll J. Use of no-suicide contracts by psychiatrists in Minnesota. Am J Psychiatry 2000; 157(10): 1684–6

    Article  PubMed  CAS  Google Scholar 

  66. Simon RI. The suicide prevention contract: clinical, legal and risk management issues. J Am Acad Psychiatry Law 1999; 27(3): 445–50

    PubMed  CAS  Google Scholar 

  67. Schneider LS. Pharmacologic considerations in the treatment of late-life depression. Am J Geriatr Psychiatry 1996; 4 (4 Suppl. 1): S51–65

    Google Scholar 

  68. Kapur S, Mieczkowski T, Mann JJ. Antidepressant medications and the relative risk of suicide attempt and suicide. JAMA 1992; 268(24): 3441–5

    Article  PubMed  CAS  Google Scholar 

  69. Niederehe H, Schneider LS. Treatments for depression and anxiety in the aged. In: Nathan PE, Gorman JM, editors. A guide to treatments that work. New York: Oxford University Press, 1998

    Google Scholar 

  70. McCusker J, Cole M, Keller E, et al. Effectiveness of treatments of depression in older ambulatory patients. Arch Intern Med 1998; 158(7): 705–12

    Article  PubMed  CAS  Google Scholar 

  71. Frank E, Kupfer DJ, Perel JM, et al. Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1990; 47: 1093–9

    Article  PubMed  CAS  Google Scholar 

  72. Bondareff W, Alpert M, Friedhoff AJ, et al. Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life. Am J Psychiatry 2000; 157(5): 729–36

    Article  PubMed  CAS  Google Scholar 

  73. Keller MB, McCullough JP, Klein DN, et al. A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med 2000; 342(20): 1462–70

    Article  PubMed  CAS  Google Scholar 

  74. Georgotas A, McCue RE. Relapse of depressed patients after effective continuation therapy. J Affect Disord 1989; 17: 159–64

    Article  PubMed  CAS  Google Scholar 

  75. Reynolds CF, Frank E, Perel JM, et al. Combined pharmacotherapy and psychotherapy in the acute and continuation treatment of elderly patients with recurrent major depression: a preliminary report. Am J Psychiatry 1992; 149(12): 1687–92

    PubMed  Google Scholar 

  76. Georgotas A, McCue RE, Cooper TB. A placebo-controlled comparison of nortriptyline and phenelzine in maintenance therapy of elderly depressed patients. Arch Gen Psychiatry 1989; 46(9): 783–6

    Article  PubMed  CAS  Google Scholar 

  77. Meyers BS, Kakuma T, Ippolito L, et al. Nortriptyline maintenance for geriatric depression: an expansion of the Georgotas studies. Psychopharmacol Bull 1997; 33: 555

    Google Scholar 

  78. Reynolds CF, Frank E, Perel JM, et al. Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: a randomized controlled trial in patients older than 59 years. JAMA 1999; 281(1): 39–45

    Article  PubMed  CAS  Google Scholar 

  79. Frank E. Long-term prevention of recurrences in elderly patients. In: Schneider LS, Reynolds CF, Lebowitz BD, et al., editors. Diagnosis and treatment of depression in late life. Washington, DC: American Psychiatric Press, 1994: 317–29

    Google Scholar 

  80. Reynolds CF, Perel JM, Frank E, et al. Three year outcomes of maintenance nortriptyline treatment in late-life depression: a study of two fixed plasma levels. Am J Psychiatry 1999; 156(8): 1177–81

    PubMed  Google Scholar 

  81. Schou M. Suicidal behavior and prophylactic lithium treatment of major mood disorders: a review of reviews. Suicide Life Threat Behav 2000; 30(3): 289–93

    PubMed  CAS  Google Scholar 

  82. Fava M, Rosenbaum JF. Anger attacks in patients with depression. J Clin Psychiatry 1999; 60Suppl. 15: 21–4

    PubMed  Google Scholar 

  83. American Psychiatric Association. Practice guideline for the treatment of psychiatric disorders, compendium. Washington, DC: American Psychiatric Association, 2000

    Google Scholar 

  84. Tondo L, Jamison KR, Baldessarini RJ. Effect of lithium maintenance on suicidal behavior in major mood disorders. Ann N Y Acad Sci 1997; 836: 339–51

    Article  PubMed  CAS  Google Scholar 

  85. Reuters Health Information. UK adds suicide warning to SSRI antidepressants [online]. Available from URL: www.reutershealth.com/frame2/arch.html [Accessed 2001 Jan 25]

  86. Healy D, Langmaak C, Savage M. Suicide in the course of the treatment of depression. J Psychopharmcol 1999; 13(1): 94–9

    Article  CAS  Google Scholar 

  87. Stokes PE. Fluoxetine: a five-year review. Clin Ther 1993; 15(2): 216–43

    PubMed  CAS  Google Scholar 

  88. Matthews JD, Fava M. Risk of suicidality in depression with serotonergic antidepressants. Ann Clin Psychiatry 2000; 12(1): 43–50

    PubMed  CAS  Google Scholar 

  89. Isacsson G. Suicide prevention: a medical breakthrough? Acta Psychiatr Scand 2000; 102(2): 113–7

    Article  PubMed  CAS  Google Scholar 

  90. Rihmer Z, Rutz W, Pihlgren H, et al. Decreasing tendency of seasonality in suicide may indicate lowering rate of depressive suicides in the population. Psychiatry Res 1998; 81(2): 233–40

    Article  PubMed  CAS  Google Scholar 

  91. Montgomery SA. Suicide and antidepressants. Drugs 1992; 43Suppl. 2: 24–30

    Article  PubMed  Google Scholar 

  92. Lopez-Ibor JJ. Reduced suicidality with paroxetine. Eur Psychiatry 1993; 8(1 Suppl.): 17S–9S

    Google Scholar 

  93. Reynolds CF, Degenholtz H, Parker L, et al. Treatment as usual (TAU) control practices in the PROSPECT study: managing the interaction and tension between research design and ethics. Int J Geriatr Psychiatry 2001; 16(6): 602–8

    Article  PubMed  Google Scholar 

  94. Meyers BS, Alexopoulos GS. Geriatric depression. Med Clin North Am 1988; 72(4): 847–66

    PubMed  CAS  Google Scholar 

  95. Mulsant BH, Sweeney JA. Electroconvulsive therapy. In: Nussbaum PD, editor. The handbook of neuropsychology and aging. New York: Plenum Publishing, 1997: 508–14

    Google Scholar 

  96. Zielinski RJ, Roose SP, Devanand DP, et al. Cardiovascular complications of ECT in depressed patients with cardiac disease. Am J Psychiatry 1993; 150(6): 904–9

    PubMed  CAS  Google Scholar 

  97. Murray GB, Shea V, Conn DK. Electroconvulsive therapy for poststroke depression. J Clin Psychiatry 1986; 47(5): 258–60

    PubMed  CAS  Google Scholar 

  98. Hay DP. Electroconvulsive therapy in the medically ill elderly. Convuls Ther 1989; 5: 8–16

    PubMed  Google Scholar 

  99. Tew JD, Mulsant BH, Haskett RF, et al. Acute efficacy of ECT in the treatment of major depression in the old-old. Am J Psychiatry 1999; 156(12): 1865–70

    PubMed  Google Scholar 

  100. Prudic J, Sackeim HA. Electroconvulsive therapy and suicide risk. J Clin Psychiatry 1999; 60Suppl. 2: 104–10

    PubMed  Google Scholar 

  101. Bradvik L, Berglund M. Treatment and suicide in severe depression: a case-controlled study of antidepressant therapy at last contact before suicide. J ECT 1999; 16(4): 399–408

    Article  Google Scholar 

  102. Niederehe G. Psychosocial therapies with depressed older adults. In: Schneider LS, Reynolds CF, Lebowitz BD, et al., editors. Diagnosis and treatment of depression in late life. Washing ton, DC: American Psychiatric Press, 1994: 293–315

    Google Scholar 

  103. Reynolds CF, Frank E, Perel J, et al. Maintenance therapies for late-life recurrent major depression: research and review circa 1995. Int Psychogeriatr 1995; 7 Suppl.: 27–40

    Article  PubMed  Google Scholar 

  104. Thompson LW, Gallagher-Thompson D, Hanser SB, et al. Treatment of late-life depression with cognitive dysfunction. 99th Annual Convention of the American Psychological As sociation; 1991 Aug 16–20; San Francisco (CA)

  105. Beck AT, Rush AJ, Shaw BF, et al. Cognitive therapy of depression: a treatment manual. New York: Guilford Press, 1979

    Google Scholar 

  106. Beck AT, Weishaar ME. Suicide risk assessment and prediction. Crisis 1990; 11: 22–30

    PubMed  CAS  Google Scholar 

  107. Shneidman E. Definition of suicide. New York: Wiley, 1985

    Google Scholar 

  108. Duberstein PR. Openness to experience and completed suicide across the second half of life. Int Psychogeriatr 1995; 7: 183–98

    Article  PubMed  CAS  Google Scholar 

  109. American Association of Suicidology. Is there a connection between state suicide rates and the availability of mental health professionals [abstract]? News Link 2000; 26(1): 7

    Google Scholar 

  110. Rihmer Z, Rutz W, Pihlgren H. Depression and suicide on Gotland: an intensive study of all suicides before and after a depression-training programme for general practitioners. J Affect Disord 1995; 35(4): 147–52

    Article  PubMed  CAS  Google Scholar 

  111. Khuri R, Akiskal HS. Suicide prevention: the necessity of treating contributory psychiatric disorders. Psychiatr Clin North Am 1983; 6(1): 193–207

    PubMed  CAS  Google Scholar 

  112. Rutz W, von Knorring L, Walinder J. Long-term effects of an educational program for general practitioners given by the Swedish Committee for the prevention and treatment of depression. Acta Psychiatr Scand 1992; 85(1): 83–8

    Article  PubMed  CAS  Google Scholar 

  113. Henkel V, Althaus D, Hegerl U. Lessons from the Hampshire depression project [letter]. Lancet 2000; 355(9215): 1641

    Article  PubMed  CAS  Google Scholar 

  114. Mulsant BH, Alexopoulos GS, Reynolds CF, et al. Pharmacologic treatment of depression in elderly primary care patients: the PROSPECT algorithm. Int J Geriatr Psychiatry 2001; 16(6): 585–92

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

Supported in part by NIMH funded grants MH52247, MH59381 (PROSPECT), MH5219, MH4279, MH43832, MH37869 and MH01613. The authors have no conflict of interest directly relevant to the contents of this manuscript.

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Szanto, K., Gildengers, A., Mulsant, B.H. et al. Identification of Suicidal Ideation and Prevention of Suicidal Behaviour in the Elderly. Drugs Aging 19, 11–24 (2002). https://doi.org/10.2165/00002512-200219010-00002

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