Differences Between Younger and Older Adults in the Structure of Suicidal Intent and Its Correlates

• Published in: The American journal of geriatric psychiatry Vol. 18; no. 9; pp. 839 - 847
• Main Authors: Miret, Marta, M.S, Nuevo, Roberto, Ph.D, Morant, Consuelo, M.D, Sainz-Cortón, Enrique, M.D, Jiménez-Arriero, Miguel Ángel, M.D, López-Ibor, Juan J., M.D, Reneses, Blanca, M.D, Saiz-Ruiz, Jerónimo, M.D, Baca-García, Enrique, M.D, Ayuso-Mateos, José Luis, M.D
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01-09-2010; Elsevier Limited
• Subjects: Adolescent; Adult; Age Factors; Aged; Antidepressive Agents - therapeutic use; Causality; Cross-Sectional Studies; Disabled Persons - psychology; elderly; Factor Analysis, Statistical; Humans; Intention; Internal Medicine; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental Disorders - therapy; Middle Aged; Secondary Prevention; self-harm; Severity of Illness Index; Social Support; Spain; structural equation modeling; suicidal intent; Suicide; Suicide, Attempted - prevention & control; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data; Young Adult; Spain; self-harm; suicidal intent; Suicide; structural equation modeling; elderly
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1097/JGP.0b013e3181d145b0

Objective To analyze differences in the variables associated with severity of suicidal intent and in the main factors associated with intent when comparing younger and older adults. Design Observational, descriptive cross-sectional study. Setting Four general hospitals in Madrid, Spain. Participants Eight hundred seventy suicide attempts by 793 subjects split into two groups: 18–54 year olds and subjects older than 55 years. Measurements The authors tested the factorial latent structure of suicidal intent through multigroup confirmatory factor analysis for categorical outcomes and performed statistical tests of invariance across age groups using the DIFFTEST procedure. Then, they tested a multiple indicators-multiple causes (MIMIC) model including different covariates regressed on the latent factor “intent” and performed two separate MIMIC models for younger and older adults to test for differential patterns. Results Older adults had higher suicidal intent than younger adults ( z = 2.63, p = 0.009). The final model for the whole sample showed a relationship of intent with previous attempts, support, mood disorder, personality disorder, substance-related disorder, and schizophrenia and other psychotic disorders. The model showed an adequate fit (χ2[12] = 22.23, p = 0.035; comparative fit index = 0.986; Tucker-Lewis index = 0.980; root mean square error of approximation = 0.031; weighted root mean square residual = 0.727). All covariates had significant weights in the younger group, but in the older group, only previous attempts and mood disorders were significantly related to intent severity. Conclusions The pattern of variables associated with suicidal intent varies with age. Recognition, and treatment of geriatric depression may be the most effective measure to prevent suicidal behavior in older adults.