Comorbidity Profiles Identified in Older Primary Care Patients who Attempt Suicide

Details

• Alternative Title:
  J Am Geriatr Soc
• Personal Author:
  Morin, Ruth T. ; Li, Yixia ; Mackin, R. Scott ; Whooley, Mary ; Conwell, Yeates ; Byers, Amy L.
• Description:
  Objectives:
  
  To identify comorbidity profiles of older patients last seen in primary care prior to a suicide attempt, and assess attempt and clinical factors (e.g., means and lethality of attempt) associated with these profiles.
  
  Design:
  
  Cohort study and latent class analysis using VA national data (2012–2014).
  
  Setting:
  
  All Department of Veterans Affairs (VA) medical centers in the United States.
  
  Participants:
  
  2,131 patients 65 years and older who were last seen by a primary care provider prior to a first documented suicide attempt.
  
  Measurements:
  
  Fatal suicide attempt and means were identified using the National Suicide Data Repository. Non-fatal attempt was defined using the National Suicide Prevention Applications Network. Medical and psychiatric diagnoses and other variables were determined from electronic medical records.
  
  Results:
  
  Patients (mean age 74.4, 98.2% male) were clustered into 5 classes based on medical and psychiatric diagnoses: Minimal Comorbidity (23.2%); Chronic Pain-Osteoarthritis (30.1%); Depression-Chronic Pain (22.9%); Depression–Medical Comorbidity (16.5%); and High Comorbidity (7.3%). The Minimal Comorbidity and Chronic Pain-Osteoarthritis classes were most likely to attempt fatally compared to classes with higher burden of comorbidities. Overall, 61% of the sample attempted fatally, and 82.5% of suicide decedents used firearms.
  
  Conclusion:
  
  This study provides evidence that the majority of comorbidity profiles (>50%) in primary care patients attempting suicide was characterized by minimal depression diagnoses and fatal attempts, mostly with firearms. These findings suggest that more than a depression diagnosis contributes to risk and that conversations about firearm safety by medical providers may play an important role in suicide intervention and prevention.
  
  
• Subjects:
  Aged Chronic Pain Comorbidity Depression Female Firearms Hospitals, Veterans Humans Male Primary Health Care Risk Factors Suicide, Attempted United States

  More +
• Keywords:
  Comorbidity Epidemiology Firearms Late Life Suicide Primary Care
• Source:
  J Am Geriatr Soc. 67(12):2553-2559
• Pubmed ID:
  31469184
• Pubmed Central ID:
  PMC6898743
• Document Type:
  Journal Article
• Funding:
  I01 CX001119/CX/CSRD VAUnited States/ ; R49 CE002093/CE/NCIPC CDC HHSUnited States/
• Volume:
  67
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:ca34a7243f4af418bfc2d3fa8ed96540a17527b0a3a04aa66b8a27cc8b7ebca4a6f1573a5dca65656fd095133031a5b9463d5d21bba4f8b0076adf6c2eea8aa6
• Download URL:
  https://stacks.cdc.gov/view/cdc/97975/cdc_97975_DS1.pdf
• File Type:
  [PDF - 401.04 KB ]