Search results for ‘Subject term:"older people"’ Sort:
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Self-harm in older adults: systematic review
- Authors:
- TROYA M. Isabela, et al
- Journal article citation:
- British Journal of Psychiatry, 214(4), 2019, pp.186-200.
- Publisher:
- Cambridge University Press
Background: Self-harm is a major public health concern. Increasing ageing populations and high risk of suicide in later life highlight the importance of identification of the particular characteristics of self-harm in older adults. Aim: To systematically review characteristics of self-harm in older adults. Methods: A comprehensive search for primary studies on self-harm in older adults was conducted in e-databases (AgeLine, CINAHL, PsycINFO, MEDLINE, Web of Science) from their inception to February 2018. Using predefined criteria, articles were independently screened and assessed for methodological quality. Data were synthesised following a narrative approach. A patient advisory group advised on the design, conduct and interpretation of findings. Results: A total of 40 articles (n = 62 755 older adults) were included. Yearly self-harm rates were 19 to 65 per 100 000 people. Self-poisoning was the most commonly reported method. Comorbid physical problems were common. Increased risk repetition was reported among older adults with self-harm history and previous and current psychiatric treatment. Loss of control, increased loneliness and perceived burdensome ageing were reported self-harm motivations. Conclusions: Self-harm in older adults has distinct characteristics that should be explored to improve management and care. Although risk of further self-harm and suicide is high in all age cohorts, risk of suicide is higher in older adults. Given the frequent contact with health services, an opportunity exists for detection and prevention of self-harm and suicide in this population. These results are limited to research in hospital-based settings and community-based studies are needed to fully understand self-harm among older adults. (Edited publisher abstract)
Deliberate self-harm in older adults: a review of the literature from 1995 to 2004
- Authors:
- CHAN Jenifer, DRAPER Brian, BANERJEE Sube
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(8), August 2007, pp.720-732.
- Publisher:
- Wiley
In 1996 Draper reviewed critically the evidence on attempted suicide in old age in the 10 years between 1985 and 1994. The review highlighted a need for prospective controlled studies in older people with more representative samples as well as studies examining the interaction of risk factors, precipitants, motivations, psychopathology and response to treatment. The aim of this paper is to update this review and to summarise the advances in our understanding of DSH in later life. Relevant studies published between 1995 and 2004 are critically reviewed to summarise advances in the understanding of factors associated with deliberate self-harm in later life. The main advances in understanding have been to clarify the effect of personality and cultural factors, service utilisation pre and post attempt, and the (lesser) impact of socio-economic status and physical illness. Methodological weaknesses continue to include inadequate sample sizes performed on highly selected populations, inconsistent age criteria and lack of informant data on studies relating to role of personality. The authors conclude that future studies should include prospective, cross-cultural research with adequate sample sizes and which are population-based. Such approaches might confirm or refute the results generated to date and improve knowledge on factors such as the biological correlates of deliberate self-harm, service utilisation, costs and barriers to health care, and the interaction of these factors. Intervention studies to elucidate the impact of modifying these factors and of specific treatment packages are also needed.
Understanding self-harm in older people: a systematic review of qualitative studies
- Authors:
- WAND Anne Pamela Frances, et al
- Journal article citation:
- Aging and Mental Health, 22(3), 2018, pp.289-298.
- Publisher:
- Taylor and Francis
Objective: Rates of suicide in older adults are generally higher than other age groups. Although risk factors for suicide attempts, and self-harm more generally, in this population are well-characterised, many of these vulnerabilities are common to older people and individual motivations are less well understood. Qualitative research may reveal more about the underlying thought processes, meaning and experiences of older people who self-harm. Methods: A systematic review of qualitative studies examining the reasons why older people have self-harmed was undertaken by searching databases and screening the reference lists of articles. The quality of studies was critically appraised. A content analysis was performed to identify themes. Results: The search yielded eight studies of variable quality which met the inclusion criteria; three pertained to indirect self-harm (refusal to eat or take medications and self-neglect) and five related to suicidal behaviour. Themes emerging from the analysis of studies of people who had self-neglected included control, impaired decision-making and coping skills and threats to self-identity and continuity. In those who had suicidal behaviour, themes related to loss of and regaining control; alienation, disconnectedness and invisibility; meaningless and raison d'etre; and accumulated suffering and a ‘painful life’. Conclusions: There is scant literature evaluating self-harm in older people using qualitative methods. Nonetheless, this review suggests that active and passive self-harm should be considered as distinct entities as the underlying motivations and intents differ. Understanding individual perceptions and experiences which lead to self-harm may guide clinicians in delivering more sensitive, holistic interventions and counter ageism. (Publisher abstract)
The association of physical illness and self-harm resulting in hospitalisation among older people in a population-based study
- Authors:
- MITCHELL Rebecca, et al
- Journal article citation:
- Aging and Mental Health, 21(3), 2017, pp.279-288.
- Publisher:
- Taylor and Francis
Objectives: This research aims to identify the association of physical illness with hospitalisations following self-harm compared to non-self-harm injury among older people. Method: A population-based cohort study of individuals aged 50+ years admitted to hospital either for a self-harm or a non-self-harm injury using linked hospital admission and mortality records during 2003–2012 in New South Wales, Australia was conducted. Logistic regression and survival plots were used to examine the association of 21 physical illnesses and mortality at 12 months by injury intent, respectively. Age-adjusted health outcomes, including length of stay, readmission and mortality were examined by injury intent. Results: There were 12,111 hospitalisations as a result of self-harm and 474,158 hospitalisations as a result of non-self-harm injury. Self-harm compared to non-self-harm hospitalised injury was associated with higher odds of mental health conditions (i.e. depression, schizophrenia, bipolar and anxiety disorders), neurological disorders (excluding dementia), other disorders of the nervous system, diabetes, chronic lower respiratory disease, liver disease, tinnitus and pain. Tinnitus, pain, malignancies and diabetes all had a higher likelihood of occurrence for self-harm compared to non-self-harm hospitalisations even after adjusting for mental health conditions, number of comorbidities and alcohol and drug dependency. Conclusion: Older people who are experiencing chronic health conditions, particularly tinnitus, malignancies, diabetes and chronic pain may be at risk of self-harm. Targeted screening may assist in identifying older people at risk of self-harm. (Edited publisher abstract)
Self-Injurious behavior in older adults with intellectual disabilities
- Authors:
- GLAESSER Richard S., PERKINS Elizabeth A.
- Journal article citation:
- Social Work: A journal of the National Association of Social Workers (NASW), 58(3), 2013, pp.213-221.
- Publisher:
- Oxford University Press
Self-injurious behavior (SIB) is a distressing type of problem behaviour that may be exhibited in individuals with intellectual disabilities (IDs). This article provides an overview of SIB, its underlying causes and functions, as well as other key variables associated with its manifestation. Adults with IDs are routinely living longer. Given this rapidly emerging and expanding population, special attention is given to SIB in aging adults with IDs that may result from age-related risk factors. Risks include increasing and unresolved health issues, physical changes, declining physical abilities, transitions to new residential environments, and the potential for experiencing loss and bereavement. The article concludes with practice implications for social workers who may encounter older individuals with IDs and SIB. (Publisher abstract)
Risk factors for repetition and suicide following self-harm in older adults: multicentre cohort study
- Authors:
- MURPHY Elizabeth, et al
- Journal article citation:
- British Journal of Psychiatry, 200(5), May 2012, pp.399-404.
- Publisher:
- Cambridge University Press
Self harm is an important risk factor for suicide, and the risk is said to increase markedly with age. The aim of this study was to calculate self-harm rates, risk factors for repetition and rates of suicide following self-harm in adults aged 60 years and over. A large prospective, population-based study was conducted among patients presenting with self harm to six general hospitals in three cities in England between 2000 and 2007. In total 1177 older adults presented with self-harm and 12.8% repeated self-harm within 12 months. The median age was 68 years and 56% of the cohort was female. Independent risk factors for repetition were previous self-harm, previous psychiatric treatment and age 60–74 years. Following self-harm, 1.5% died by suicide within 12 months. The risk of suicide was 67 times that of older adults in the general population. Men aged 75 years and above had the highest suicide rates. It is concluded that older adults presenting to hospital with self-harm are a high-risk group for subsequent suicide, particularly older men.
Suicide and self-harm in older people
- Author:
- DENNIS Michael S.
- Journal article citation:
- Quality in Ageing, 10(1), March 2009, pp.16-23.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
This article considers the spectrum of suicidal behaviour in later life. The first section discusses completed suicide, the second self-harm, and the third suicidal ideation (tiredness of lie, death wishes and suicidal thoughts). Finally, key areas in the prevention of suicide and self-harm in older people are discussed.
Self-harm in older people with depression: comparison of social factors, life events and symptoms
- Authors:
- DENNIS Michael, et al
- Journal article citation:
- British Journal of Psychiatry, 186(6), June 2005, pp.538-539.
- Publisher:
- Cambridge University Press
Studying non-fatal self-harm in older adults may provide insight into suicidal behaviour in this age group. The objectives of the study were to determine clinical factors that might help to differentiate those older adults with depression who are most at risk of self-harm and suicide. The authors examined social factors, life events, hopelessness and other depression symptoms in a group of 48 older people with depression referred following an episode of self-harm compared with 50 similarly aged people with depression who had no history of self-harm. The groups were similar in many respects, although those in the self-harm group were more likely to have a poorly integrated social network and were more hopeless
Lifetime trauma and suicide attempts in older clients with severe mental illness
- Authors:
- O'HARE Thomas, SHERRER Margaret
- Journal article citation:
- Social Work in Mental Health, 16(5), 2018, pp.505-517.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Research examining links between lifetime trauma and suicide attempts in older clients with severe mental illness (SMI) is scarce. The authors examined associations among six common forms of lifetime trauma and lifetime suicide attempts while controlling for other known correlates of suicide attempts including gender, psychiatric symptoms, thoughts of self-harm/suicide, and lifetime self-injury in 174 community mental health clients with severe mental illness who were 50 years of age or older. Almost all clients reported at least one traumatic event with a mean of twelve, more than half had attempted suicide at least once, and about one-third had made multiple suicide attempts. Regression revealed that four factors were significantly associated with lifetime suicide attempts: lifetime self-injurious behaviours, lifetime physical abuse, lifetime frequency of having witnessed severe violence, and lifetime homelessness. Lifetime self-injury accounted for the most variance in suicide attempts, but having been physically abused accounted for the most variance in suicide attempts among the six trauma items. Lifetime trauma should be carefully screened in older clients with severe mental illness given preliminary evidence that it might be linked to suicide risk. Limitations of this study include the cross-sectional design. (Edited publisher abstract)
The survival and characteristics of older people with and without dementia who are hospitalised following intentional self-harm
- Authors:
- MITCHELL Rebecca, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(8), 2017, pp.892-900.
- Publisher:
- Wiley
Objective: Characteristics of older people with and without dementia who are hospitalised following self-harm remains largely unexplored. This research compares the characteristics of older people with and without dementia who self-harm, compares associations of mental health-related diagnoses with those hospitalised for a self-harm and a non-self-harm injury and examines mortality by injury intent. Method: A population-based study of individuals aged 50+ years with and without dementia admitted to hospital for a self-harm injury (and those with other injuries) using linked hospital admission and mortality records during 2003–2012 in New South Wales (NSW), Australia. Health outcomes, including hospital length of stay (LOS), 28-day readmission and 30-day and 12-month mortality were examined by dementia status. Results: There were 427 hospitalisations of individuals with dementia and 11,684 hospitalisations of individuals without dementia following self-harm. The hospitalisation rate for self-harm for individuals with dementia aged 60+ years was double the rate for individuals without dementia (72.2 and 37.5 per 100,000). For both older people with and without dementia, those who self-harmed were more likely to have co-existent mental health and alcohol use disorders than individuals who had a non-self-harm injury. Individuals with dementia had higher 12-month mortality rates, 28-day readmission and longer LOS than individuals without dementia. Conclusion: Dementia is associated with an increased risk of hospitalisation for self-harm in older people and worse outcomes. The high rate of coexistent mental health conditions suggests that interventions which reduce behavioural and psychological symptoms of dementia might reduce self-harm in people with dementia (Publisher abstract)