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Suicidal and Death Ideation in Older Primary Care Patients With Depression, Anxiety, and At-Risk Alcohol Use
Abstract
The authors identified correlates of active suicidal ideation and passive death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use. Participants included 2,240 older primary care patients (age 65+), who were identified in three mutually exclusive groups on the basis of responses to the Paykel suicide questions: No Ideation, Death Ideation, and Suicidal Ideation. Chi-square, ANOVA, and polytomous logistic regression analyses were used to identify characteristics associated with suicidal ideation. The highest amount of suicidal ideation was associated with co-occurring major depression and anxiety disorder (18%), and the lowest proportion occurred in at-risk alcohol use (3%). Asians have the highest (57%) and African Americans have the lowest (27%) proportion of suicidal or death ideation. Fewer social supports and more severe symptoms were associated with greater overall ideation. Death ideation was associated with the greatest medical comorbidity and highest service utilization. Contrary to previous reports, authors failed to find that active suicidal ideation was associated with increased contacts with healthcare providers. Accordingly, targeted assessment and preventive services should be emphasized for geriatric outpatients with co-occurring depression and anxiety, social isolation, younger age, and Asian or Caucasian race.
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“Seven studies (with eight publications) focused on death wishes/suicide ideation [27,28,29,30,31,32,33,34].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“Bartels studied correlates of passive death ideation and active suicide ideation in over 2,000 U.S. primary care patients with depression, anxiety or problematic alcohol use [28]; no association was found with marital status.”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“Regarding living alone, no association was seen with death ideation in the Bartels study [28].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“Further, no relationship was observed with suicide ideation in that study, which was also the case in the study by Raue [31], and the Yen study from Taiwan [34].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“Several U.S. studies (n = 3) examined frequency of social contact, with studies by Bartels and Rowe documenting associations between limited social contact and suicidal ideation [28,32]”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“Four studies (two from the U.S., one from Hong-Kong and one from Taiwan) examined aspects of religiosity [28,34,38,41].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“No association could be shown between frequency of religious activity and either death ideation (i.e., wishes for death) or suicide ideation in primary care patients in the U.S.-based study by Bartels [28].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“However, when specifically considering contacts with children and relatives, null results were found for death ideation (i.e., passive wishes for death) in the Bartels study [28] and for suicide in the Turvey study [41].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
In the citing paper
“Three of the five analyses of frequency of social contact (across 3 studies, all from the U.S. [28,32,41]) yielded significant associations between low contact and both suicide ideation and suicide.”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [28]
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Metadata
- Authors
- Bartels, S. J., Coakley, E., Oxman, T. E., Constantino, G., Oslin, D., Chen, H., Zubritsky, C., Cheal, K., Durai, U. N. B., Gallo, J. J., Llorente, M., & Sanchez, H.
- Affiliations
- John Snow (United States) (US)
- Philadelphia VA Medical Center (US)
- New York University (US)
- University of Pennsylvania (US)
- Brigham and Women's Hospital (US)
- University of Illinois Chicago (US)
- University of Miami (US)
- Corresponding author
- Bartels, Stephen J.
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 10
- Issue
- 4
- Pages
- 417-427
- ISSN
- 1064-7481 (ISSN-L)
- OpenAlex
- W2144906876
- Cited by
- 216
- References
- 54
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 11 · 2020: 13 · 2019: 7 · 2018: 7 · 2017: 9 · 2016: 8 · 2015: 10 · 2014: 12 · 2013: 18 · 2012: 15
- FWCI
- 12.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- suicidal ideation, death ideation, older adults, primary care, depression, anxiety, at-risk alcohol use, comorbidities, social support, health care utilization, suicide prevention, racial differences, geriatric outpatients
- MeSH terms
- Aged, Anxiety, Attitude to Death, Cross-Sectional Studies, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Primary Health Care, Risk Factors, Suicide, Attempted
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