Geriatric suicides and the burden of chronic diseases - a retrospective evaluation of suicides in a specific, well-described population.

Abstract

Geriatric suicide has specific characteristics that are not always clear. Our objective was to assess the characteristics of geriatric suicides at a precise moment in time, in a well-described population living in a particular geographic area (year 2003, Galatzi county, Romania).A unique, significant increase in all-ages suicide rates was observed in 2003. Geriatric suicide rates followed a different pattern. The local rate was significantly higher than the national one for two consecutive years (2003 and 2004). The difference between years was not significant. All suicide scenes were fully investigated by forensic teams. Medical history, chronic use of medication, heavy alcohol consumption, chronic pain, frailty and recent grief were mentioned in the history of most of the cases. The post-mortem histopathology findings were typical for the method of suicide used and similar for both analysed years. 75% of cases had a high burden of chronic diseases (≥3 histopathological diagnoses per subject). Only 32% of cases had a clear psychiatric diagnosis. The low number of cases (71) and the absence of a control group precluded us from drawing more specific assumptions.Our findings support the idea that, in geriatric competent subjects, the proportion of subjects bearing a heavy burden of chronic diseases will impact the suicide rate more than psychiatric conditions even for elderly people living in an area where there is a strong culture against suicide.