Life events and psychosocial factors in elderly suicides—A case-control study
Abstract
Background. Stressful life events, such as family conflicts, separation, bereavement, somatic illness and financial problems are common antecedents of suicide. Studies on suicide among younger persons dominate the literature, despite the fact that a large proportion of suicides occur among elderly persons. Methods. The occurrence of stressful life events was investigated among elderly suicide cases and population controls. The study was conducted in the southwestern part of Sweden and included 85 persons (46 males and 39 females) 65 years and above who had committed suicide from January 1994 to May 1996. Population controls (84 males and 69 females) were randomly selected. Interviews were carried out with the controls and with informants for the suicide cases. Questions on sociodemographic background, mental and somatic health status, and life events (0–6, 7–12 and 13–24 months preceding suicide/interview) were included in the interviews. Results. Somatic illness, family discord and financial trouble were significant risk factors during all three time periods. Other risk factors were mental disorder, lower education, feelings of loneliness and previous suicide in the family. Factors associated with a decreased risk included active participation in organizations and having a hobby. Variables that remained in the multivariate logistic regression model were mental disorder (men, odds ratio (OR) = 62·4, 95% CI 17·9–217·5; women, OR = 55·9, 95% CI 14·1–222·3) and family discord (men, OR = 10·0, 95% CI 1·7–59·8; women, OR = 9·2, 95% CI 1·9–44·8). Conclusions. Mental disorder and family discord were the two major risk factors for suicide among elderly men and women.
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Only three studies (with four publications) examined suicide/fatal suicidal behavior.
“Only three studies (with four publications) examined suicide/fatal suicidal behavior [38,40,41,42].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Residential change over the past two years was not associated with death by suicide in the Swedish study by Rubenowitz, nor in Waern age-stratified analyses.
“Residential change over the past two years was not associated with death by suicide in the Swedish study by Rubenowitz [40], nor when Waern conducted separate analyses for those aged 65–74 years and those aged above 75 [42].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Decreased suicide risk was observed for Swedish men and women who participated in organizations in the Rubenowitz study.
“Decreased suicide risk was observed for Swedish men and women who participated in organizations in the study by Rubenowitz [40].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
No association between living alone and suicide was found in the Rubenowitz study, with similar results for men and women.
“No such association was found, however in the Rubenowitz study that focused on suicide in the same region [40] and similar results were observed for men and women.”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Loneliness was associated with increased risk for both non-fatal and fatal suicidal behavior in Swedish studies.
“Loneliness—the inner, subjective experience of social disconnectedness—was examined in two Swedish studies (across three publications), documenting increased risk for both non-fatal and fatal suicidal behavior [39,40,42].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Interpersonal conflict over the prior 24 months was a significant predictor of suicide in the Swedish psychological autopsy study.
“Analysis of data from the Swedish psychological autopsy study revealed that interpersonal conflict over the prior 24 months was a significant predictor of suicide [40,42].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Relationship discord was associated with non-fatal and fatal suicidal behavior in three publications.
“An index of discordant connectedness—relationship discord—was examined in three publications, documenting associations with non-fatal [38] and fatal suicidal behavior [38,40,42].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
With the exception of the study by Rubenowitz and colleagues, sex-specific data for older adults were lacking.
“with the exception of the study by Rubenowitz and colleagues [40], sex-specific data for older adults were lacking.”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Loneliness was associated with increased risk of suicide in both men and women in the Rubenowitz study.
“Rubenowitz reported that loneliness was associated with increased risk of suicide in both men and women [40].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Consistent results were found for subjective measures of social connectedness: perceived social support (two U.S. studies) and loneliness (two Swedish studies).
“Though investigated in fewer studies, consistent results were also found for subjective measures of social connectedness—perceived social support (two U.S. studies [31,41]) and loneliness (two Swedish studies [39,40,42]).”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [40]
Serious relationship and financial problems distinguished older adult suicides and near fatal suicide attempters from controls in New Zealand, findings replicated in Sweden.
“Serious relationship and financial problems distinguished older adult suicides and near fatal suicide attempters from controls in New Zealand (20), findings replicated by Rubenowitz and colleagues in Sweden (16).”
From Suicide in older adults (2011) · cites this paper as [16]
Psychological autopsy case-control studies provide remarkably consistent findings.
“a variety of investigators have applied it in case control studies that provide remarkably consistent findings (7-21).”
From Suicide in older adults (2011) · cites this paper as [16]
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- Authors
- RUBENOWITZ, E., WAERN, M., WILHELMSON, K., & ALLEBECK, P.
- Affiliations
- University of Gothenburg (SE)
- ORCID
- WILHELMSON, K.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2001-10
- Volume
- 31
- Issue
- 7
- Pages
- 1193-1202
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2079882622
- Cited by
- 277
- References
- 27
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 15 · 2021: 12 · 2020: 7 · 2019: 8 · 2018: 16 · 2017: 12 · 2016: 7 · 2015: 15 · 2014: 14 · 2013: 24 · 2012: 20
- FWCI
- 8.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- elderly suicide, life events, psychosocial risk factors, mental illness, family conflict, somatic diseases, financial problems, loneliness, social participation (health and rehabilitation), suicide prevention
- MeSH terms
- Aged, Aged, 80 and over, Catchment Area, Health, Female, Humans, Life Change Events, Male, Psychiatric Status Rating Scales, Psychophysiologic Disorders, Surveys and Questionnaires, Suicide, Sweden, Case-Control Studies
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