Prevalence of mental disorders among elderly men
a systematic review and meta-analysis
Keywords:
Aged, Men, Mental disorders, Depression, SchizophreniaAbstract
BACKGROUND: Elderly men have been characterized as a group vulnerable to suicide, motivated by loneliness, loss of loved ones and feelings of uselessness to family members. OBJECTIVES: To ascertain the prevalence of different mental disorders among elderly men who attempted suicide. DESIGN AND SETTING: Systematic review of observational studies developed as a result of a partnership between two postgraduate schools (Lagarto and Uberlândia). METHODS: An electronic search was performed in eight electronic databases, including “grey literature”, in January 2019. Observational studies that assessed mental disorders among men older than 60 years who attempted suicide were eligible for inclusion. RESULTS: Among the disorders evaluated, mood disorders had the highest prevalence (42.0%; 95% confidence interval, CI: 31.0-74.0%; I2: 0.0%; P = 0.763), followed by substance use-related disorders (41.0%; 95% CI: 8.0-74.0%; I2: 96.4; P < 0.001) and, lastly, schizophrenic disorders (5.0%; 95% CI: 0.0%-14.0%; I2: 80.3%; P = 0.024). CONCLUSIONS: It seems that mood disorders and substance use-related disorders are quite prevalent among elderly men with mental disorders who attempted suicide. It is important to consider the role of healthcare services in making early diagnoses of mental disorders among elderly men, in order to diminish the chances of suicide attempts among them. YSTEMATIC REVIEW REGISTRATION: CRD42018105981.
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References
World Health Organization (WHO). Quality of suicide mortality data. Geneva: World Health Organization; 2015.
Bertolote JM, De Leo D. Global suicide mortality rates - a light at the end of the tunnel? Crisis. 2012;33(5):249-53. PMID: 22935272; doi: 10.1027/0227-5910/a000180.
Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2010. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística; 2013.
De Leo D, Burgis S, Bertolote JM, Kerkhof A, Bille-Brahe U. Definitions of suicidal behaviour. In: Suicidal behavior: Theories and research findings. Cambridge: Hogrefe & Huber; 2004, p. 17-40. ISBN-10: 0889372675; ISBN-13: 978-0889372672.
Park JY, Han JW, Jeong H, et al. Suicidal behaviors in elderly Koreans: one-month-point prevalence and factors related to suicidality. J Affect Disord. 2013;150(1):77-83. PMID: 23497791; doi: 10.1016/j.jad.2013.02.025.
Koo YW, Kõlves K, De Leo D. Suicide in older adults: a comparison with middle-aged adults using the Queensland Suicide Register. Int Psychogeriatr. 2017;29(3):419-30. PMID: 27852335; doi: 10.1017/S1041610216001848.
Vargas Sanabria M, Vega Chaves JC, Montero Solano G, Hernandez Romero G. Suicidio en adultos mayores en Costa Rica durante el período 2010-2014. Med Leg Costa Rica. 2017;34(1):2-25.
Minayo MC, Pinto LW, Assis SG, Cavalcante FG, Mangas RM. Tendência da mortalidade por suicídio na população brasileira e idosa, 1980-2006 [Trends in suicide mortality among Brazilian adults and elderly, 1980 - 2006]. Rev Saude Publica. 2012;46(2):300-9. PMID: 22437858; doi: 10.1590/s0034-89102012000200012.
Shao Y, Zhu C, Zhang Y, et al. Epidemiology and temporal trend of suicide mortality in the elderly in Jiading, Shanghai, 2003-2013: a descriptive, observational study. BMJ Open. 2016;6(8):e012227. PMID: 27543591; doi: 10.1136/bmjopen-2016-012227.
Liu HL. Epidemiologic characteristics and trends of fatal suicides among the elderly in Taiwan. Suicide Life Threat Behav. 2009;39(1):103-13. PMID: 19298155; doi: 10.1521/suli.2009.39.1.103.
Zhong BL, Chiu HF, Conwell Y. Rates and characteristics of elderly suicide in China, 2013-14. J Affect Disord. 2016;206:273-9. PMID: 27639861; doi: 10.1016/j.jad.2016.09.003.
Ciulla L, Lopes Nogueira E, da Silva Filho IG, et al. Suicide risk in the elderly: data from Brazilian public health care program. J Affect Disord. 2014;152-154:513-6. PMID: 23948635; doi: 10.1016/j.jad.2013.05.090.
Koo YW, Kõlves K, De Leo D. Suicide in older adults: differences between the young-old, middle-old, and oldest old. Int Psychogeriatr. 2017;29(8):1297-306. PMID: 28511737; doi: 10.1017/S1041610217000618.
Maciejewski DF, Renteria ME, Abdellaoui A, et al. The Association of Genetic Predisposition to Depressive Symptoms with Non-suicidal and Suicidal Self-Injuries. Behav Genet. 2017;47(1):3-10. PMID: 27590903; doi: 10.1007/s10519-016-9809-z.
Zai CC, de Luca V, Strauss J, et al. Genetic Factors and Suicidal Behavior. In: Dwivedi Y, editor. The neurobiological basis of suicide. Boca Raton (FL): CRC Press/Taylor & Francis; 2012. ISBN-13: 978-1-4398-3881-5.
Cao XL, Zhong BL, Xiang YT, et al. Prevalence of suicidal ideation and suicide attempts in the general population of China: A meta-analysis. Int J Psychiatry Med. 2015;49(4):296-308. PMID: 26060259; doi: 10.1177/0091217415589306.
Mościcki EK. Epidemiology of suicide. Int Psychogeriatr. 1995;7(2):137-48. PMID: 8829423.
Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1. PMID: 25554246; doi: 10.1186/2046-4053-4-1.
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008-12. PMID: 10789670; doi: 10.1001/jama.283.15.2008.
Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration; 2011. Available from: Available from: https://handbook-5-1.cochrane.org/ Accessed in 2020 (Feb 6).
The Joanna Briggs Institute. Reviewers’ Manual: 2014 edition. Australia: The Joanna Briggs Institute; 2014. Available from: Available from: https://nursing.lsuhsc.edu/JBI/docs/ReviewersManuals/Economic.pdf Accessed in 2019 (Oct 31).
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177-88. PMID: 3802833; doi: 10.1016/0197-2456(86)90046-2.
Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401-6. PMID: 21208779; doi: 10.1016/j.jclinepi.2010.07.015.
Suominen K, Isometsä E, Lönnqvist J. Elderly suicide attempters with depression are often diagnosed only after the attempt. Int J Geriatr
Psychiatry. 2004;19(1):35-40. PMID: 14716697; doi: 10.1002/gps.1031.
Almeida OP, McCaul K, Hankey GJ, et al. Suicide in older men: The health in men cohort study (HIMS). Prev Med. 2016;93:33-8. PMID: 27663430; doi: 10.1016/j.ypmed.2016.09.022.
Moola S, Munn Z, Tufanaru C, et al. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z, editors. Joanna Briggs Institute Reviewer’s Manual. The Joanna Briggs Institute; 2017. Available from Available from https://reviewersmanual.joannabriggs.org/ Accessed in 2020 (Mar 17).
Suominen K, Isometsä E, Haukka J, Lonnqvist J. Substance use and male gender as risk factors for deaths and suicide--a 5-year follow-up study after deliberate self-harm. Soc Psychiatry Psychiatr Epidemiol. 2004;39(9):720-4. PMID: 15672292; doi: 10.1007/s00127-004-0796-7.
» https://doi.org/10.1007/s00127-004-0796-7
Suresh Kumar PN, Anish PK, George B. Risk factors for suicide in elderly in comparison to younger age groups. Indian J Psychiatry. 2015;57(3):249-54. PMID: 26600577; doi: 10.4103/0019-5545.166614.
Conejero I, Olié E, Courtet P, Calati R. Suicide in older adults: current perspectives. Clin Interv Aging. 2018;13:691-9. PMID: 29719381; doi: 10.2147/CIA.S130670.
Roberts SE, John A, Kandalama U, et al. Suicide following acute admissions for physical illnesses across England and Wales. Psychol Med. 2018;48(4):578-91. PMID: 28714426; doi: 10.1017/S0033291717001787.
John A, Patel U, Rusted J, Richards M, Gaysina D. Affective problems and decline in cognitive state in older adults: a systematic review and meta-analysis. Psychol Med. 2019;49(3):353-365. PMID: 29792244; doi: 10.1017/S0033291718001137.
Walters K, Falcaro M, Freemantle N, King M, Ben-Shlomo Y. Sociodemographic inequalities in the management of depression in adults aged 55 and over: an analysis of English primary care data. Psychol Med. 2018;48(9):1504-13. PMID: 29017624; doi: 10.1017/S0033291717003014.
Fiske A, Wetherell JL, Gatz M. Depression in older adults. Annu Rev Clin Psychol. 2009;5:363-89. PMID: 19327033; doi: 10.1146/annurev.clinpsy.032408.153621.
Sözeri-Varma G. Depression in the elderly: clinical features and risk factors. Aging Dis. 2012;3(6):465-71. PMID: 23251852.
Conwell Y, Van Orden K, Caine ED. Suicide in older adults. Psychiatric Clin North Am. 2011;34(2):451-68. PMID: 21536168; doi: 10.1016/j.psc.2011.02.002.
Lawrence D, Almeida OP, Hulse GK, Jablensky AV, Holman CD. Suicide and attempted suicide among older adults in Western Australia. Psychol Med. 2000;30(4):813-21. PMID: 11037089; doi: 10.1017/s0033291799002391.
Karvonen K, Räsänen P, Hakko H, et al. Suicide after hospitalization in the elderly: a population based study of suicides in Northern Finland between 1988-2003. Int J Geriatr Psychiatry. 2008;23(2):135-41. PMID: 17583897; doi: 10.1002/gps.1853.
Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disord. 2010;12(1):1-9. PMID: 20148862; doi: 10.1111/j.1399-5618.2009.00786.x.
Scaini G, Quevedo J. Suicide rates in the United States continue to rise. Are rates in Brazil underestimated? Braz J Psychiatr. 2018;40(4):347-8. PMID: 30156656; doi: 10.1590/1516-4446-2018-4004.
Aizenberg D, Olmer A, Barak Y. Suicide attempts amongst elderly bipolar patients. J Affect Disord. 2006;91(1):91-4. PMID: 16434107; doi: 10.1016/j.jad.2005.12.013.
Hor K, Taylor M. Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol. 2010;24(4 Suppl):81-90. PMID: 20923923; doi: 10.1177/1359786810385490.
Conwell Y, Brent D. Suicide and aging. I: Patterns of psychiatric diagnosis. Int Psychogeriatr. 1995;7(2):149-64. PMID: 8829424.
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. PMID: 8678167; doi: 10.1176/ajp.153.8.1001.
Draper B. Attempted suicide in old age. Int J Geriatr Psychiatry. 1996;11(7):577-87. doi: 10.1002/(SICI)1099-1166(199607)11:7<577::AID-GPS362>3.0.CO;2-V.
Waern M, Rubenowitz E, Runeson B, et al. Burden of illness and suicide in elderly people: case-control study. BMJ. 2002;324(7350):1355. PMID: 12052799; doi: 10.1136/bmj.324.7350.1355.
Christiansen E, Jensen BF. Risk of repetition of suicide attempt, suicide or all deaths after an episode of attempted suicide: a register-based survival analysis. Aust N Z J Psychiatry. 2007;41(3):257-65. PMID: 17464707; doi: 10.1080/00048670601172749.
Girianelli RV, Pacheco Ferreira A, Besserman Vianna M, et al. Qualidade das notificações de violências interpessoal e autoprovocada no Estado do Rio de Janeiro, Brasil, 2009-2016 [Quality of the notifications of interpersonal and self-inflicted violence in the state of Rio de Janeiro, Brazil, 2009-2016]. Cad Saúde Colet. 2018;26(3):318-26. doi: 10.1590/1414-462x201800030075.