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The differential roles of trauma, posttraumatic stress disorder, and comorbid depressive disorders on suicidal ideation in the elderly population.
J Clin Psychiatry. 2012 Aug; 73(8):1141-6.JC

Abstract

OBJECTIVE

Although depression is the strongest predictor for the full spectrum of suicidal ideation, several other mental disorders, eg, posttraumatic stress disorder (PTSD), are associated with suicidal ideation too. This study investigates whether suicidal ideation is specifically associated with PTSD or if this association is fully or partially mediated by comorbid depressive disorders.

METHOD

A representative sample of 1,659 people aged 60-85 years from the German general population was examined by using self-rating instruments for PTSD, depression, and suicidal ideation in May and June 2008 in a cross-sectional study. Participants were diagnosed with PTSD when they met criteria A, B, C, and D for PTSD according to DSM-IV-TR. Suicidal ideation was used as the primary outcome measure.

RESULTS

In our sample, 7.3% of subjects reported suicidal ideation within the last 2 weeks. Suicidal ideation was associated with a higher number of traumatic experiences (mean = 1.13 vs 0.78; t = -3.20; P ≤ .001) and prevalence of PTSD (12.4% vs 3.4%, χ2 = 23.39, P < .001) than in subjects without suicidal ideation. In logistic regression analyses including age and sex, traumatic experiences were associated with suicidal ideation (OR = 1.16, P = .011). After including PTSD in the model, this association was fully explained by PTSD. Moreover, PTSD was associated with suicidal ideation (OR = 3.33, P < .001), but after including depression in the model, the association of PTSD and suicidal ideation was fully mediated by depression (OR = 1.61, P < .001).

CONCLUSIONS

The results of our study indicate that PTSD is associated with suicidal ideation, but this association was fully explained by comorbid depressive symptoms in the elderly general population. Thus, screening for depressive symptoms as well as administering an appropriate therapy seems the best way to prevent suicide attempts in the elderly, even in those patients with traumatic experiences and/or PTSD.

Authors+Show Affiliations

University of Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Str 55, 04103 Leipzig, Germany. Heide.Glaesmer@medizin.uni-leipzig.deNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22967778

Citation

Glaesmer, Heide, and Elmar Braehler. "The Differential Roles of Trauma, Posttraumatic Stress Disorder, and Comorbid Depressive Disorders On Suicidal Ideation in the Elderly Population." The Journal of Clinical Psychiatry, vol. 73, no. 8, 2012, pp. 1141-6.
Glaesmer H, Braehler E. The differential roles of trauma, posttraumatic stress disorder, and comorbid depressive disorders on suicidal ideation in the elderly population. J Clin Psychiatry. 2012;73(8):1141-6.
Glaesmer, H., & Braehler, E. (2012). The differential roles of trauma, posttraumatic stress disorder, and comorbid depressive disorders on suicidal ideation in the elderly population. The Journal of Clinical Psychiatry, 73(8), 1141-6. https://doi.org/10.4088/JCP.11m07598
Glaesmer H, Braehler E. The Differential Roles of Trauma, Posttraumatic Stress Disorder, and Comorbid Depressive Disorders On Suicidal Ideation in the Elderly Population. J Clin Psychiatry. 2012;73(8):1141-6. PubMed PMID: 22967778.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The differential roles of trauma, posttraumatic stress disorder, and comorbid depressive disorders on suicidal ideation in the elderly population. AU - Glaesmer,Heide, AU - Braehler,Elmar, PY - 2011/12/12/received PY - 2012/03/05/accepted PY - 2012/9/13/entrez PY - 2012/9/13/pubmed PY - 2012/11/14/medline SP - 1141 EP - 6 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 73 IS - 8 N2 - OBJECTIVE: Although depression is the strongest predictor for the full spectrum of suicidal ideation, several other mental disorders, eg, posttraumatic stress disorder (PTSD), are associated with suicidal ideation too. This study investigates whether suicidal ideation is specifically associated with PTSD or if this association is fully or partially mediated by comorbid depressive disorders. METHOD: A representative sample of 1,659 people aged 60-85 years from the German general population was examined by using self-rating instruments for PTSD, depression, and suicidal ideation in May and June 2008 in a cross-sectional study. Participants were diagnosed with PTSD when they met criteria A, B, C, and D for PTSD according to DSM-IV-TR. Suicidal ideation was used as the primary outcome measure. RESULTS: In our sample, 7.3% of subjects reported suicidal ideation within the last 2 weeks. Suicidal ideation was associated with a higher number of traumatic experiences (mean = 1.13 vs 0.78; t = -3.20; P ≤ .001) and prevalence of PTSD (12.4% vs 3.4%, χ2 = 23.39, P < .001) than in subjects without suicidal ideation. In logistic regression analyses including age and sex, traumatic experiences were associated with suicidal ideation (OR = 1.16, P = .011). After including PTSD in the model, this association was fully explained by PTSD. Moreover, PTSD was associated with suicidal ideation (OR = 3.33, P < .001), but after including depression in the model, the association of PTSD and suicidal ideation was fully mediated by depression (OR = 1.61, P < .001). CONCLUSIONS: The results of our study indicate that PTSD is associated with suicidal ideation, but this association was fully explained by comorbid depressive symptoms in the elderly general population. Thus, screening for depressive symptoms as well as administering an appropriate therapy seems the best way to prevent suicide attempts in the elderly, even in those patients with traumatic experiences and/or PTSD. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/22967778/The_differential_roles_of_trauma_posttraumatic_stress_disorder_and_comorbid_depressive_disorders_on_suicidal_ideation_in_the_elderly_population_ L2 - http://www.psychiatrist.com/jcp/article/pages/2012/v73n08/v73n0816.aspx DB - PRIME DP - Unbound Medicine ER -