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Cognitive Therapy for Suicidal Older Adults

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Suicide among older adults is a major public health problem. In 2004, there were approximately 5,198 suicides among those 65 and older in the United States according to the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC, n.d.). The rate of suicide for adults over the age of 65 was 14.3 per 100,000 and this rate increases with age. Moreover, men over the age of 65 are especially at risk for suicide given the suicide rate of 30.0 per 100,000. Given the high rates of suicide among older adults, there is an urgent need to identify the risk and protective factors associated with suicide behavior in this population. The design of effective suicide prevention strategies for older adults hinges on the identification of specific, modifiable risk factors.

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References

  • Alexopoulos, G. S., Bruce, M. L., Hull, J., Sirey, J. A., & Kakuma, T. (1999). Clinical determinants of suicidal ideation and behavior in geriatric depression. Archives of General Psychiatry, 56, 1048–1053.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2003). Practice guideline for the assessment and treatment of patients with suicidal behaviors. Arlington, VA: American Psychiatric Association.

    Google Scholar 

  • Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia, PA: University of Pennsylvania Press.

    Google Scholar 

  • Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: Meridian.

    Google Scholar 

  • Beck, A. T., Brown, G., Berchick, R. J., Stewart, B., & Steer, R. A. (1990). Relationship between hopelessness and ultimate suicide: A replication with psychiatric outpatients. American Journal of Psychiatry, 147, 190–195.

    PubMed  Google Scholar 

  • Beck, A. T., Brown, G. K., & Steer, R. A. (1997). Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients. Behaviour Research and Therapy, 35, 1039–1046.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Brown, G. K., Steer, R. A., Dahlsgaard, K. K., & Grisham, J. R. (1999). Suicide ideation at its worst point: A predictor of eventual suicide in psychiatric outpatients. Suicide and Life-Threatening Behavior, 29(1), 1–9.

    PubMed  Google Scholar 

  • Beck, A. T., Kovacs, M., & Weissman, A. (1975). Hopelessness and suicidal behavior: An overview. Journal of the American Medical Association, 234, 1146–1149.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of Suicidal Intention – Scale for suicide ideation. Journal of Consulting and Clinical Psychology, 47, 343–352.

    Article  PubMed  Google Scholar 

  • Beck, A. T., & Steer, R. A. (1988). Manual for the Beck Hopelessness Scale. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory Manual (2nd ed.). San Antonio, TX: Psychological Corporation; Harcourt Brace and Company.

    Google Scholar 

  • Beck A. T., Steer, R. A., Kovacs, M., & Garrison, B. (1985). Hopelessness and eventual suicide – A 10 year prospective study of patients hospitalized with suicidal ideation. American Journal of Psychiatry, 142, 559–563.

    PubMed  Google Scholar 

  • Brown, G. K., Beck, A. T., Steer, R. A., & Grisham, J. R. (2000). Risk factors for suicide in psychiatric outpatients: A 20-year prospective study. Journal of Consulting and Clinical Psychology, 68, 371–377.

    Article  PubMed  Google Scholar 

  • Brown, G. K., Tenhave, T., Henriques, G. R., Xie, S. X., Hollander, J. E., Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. Journal of the American Medical Association, 294, 563–570.

    Article  PubMed  Google Scholar 

  • Bruce, M. L., Tenhave, T., Thomas. R., Reynolds, C. F. III, Katz, I. I., Schulberg, H. C., et al. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: A randomized controlled trial. Journal of the American Medical Association, 291, 1081–1091.

    Article  PubMed  Google Scholar 

  • Byrne, G. J., & Raphael, B. (1999). Depressive symptoms and depressive episodes in recently widowed older men. International Psychogeriatrics, 11, 67–74.

    Article  PubMed  Google Scholar 

  • Campbell, J. M. (1992). Treating depression in well older adults: Use of diaries in cognitive therapy. Issues of Mental Health Nursing, 13, 19–29.

    Article  Google Scholar 

  • Carney, S. S., Rich, C. L., Burke, P. A., & Fowler, R. C. (1994). Suicide over 60: The San Diego study. Journal of the American Geriatrics Society, 42, 174–180.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (n.d.). National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Retrieved March 2, 2007, from http://www.cdc.gov/ncipc/wisqars/default.htm.

  • Clark, D. A., & Beck, A. T. (1999). Scientific foundations of cognitive theory and therapy of depression. New York: John Wiley & Sons.

    Google Scholar 

  • Conwell, Y. (2001). Suicide in later life: A review and recommendations for prevention. Suicide and Life-Threatening Behavior, 31, 32–47.

    Article  PubMed  Google Scholar 

  • Conwell, Y., & Brent, D. (1995). Suicide and aging I: Patterns of psychiatric diagnosis. International Psychogeriatrics, 7, 149–164.

    Article  PubMed  Google Scholar 

  • Conwell, Y., Dubertstein, P. R., & Caine, E. D. (2002). Risk factors for suicide in later life. Biological Psychiatry, 52, 193–204.

    Article  PubMed  Google Scholar 

  • Conwell, Y., Duberstein, P. R., Cox, C., Herrmann, J. H., Forbes, N. T., & Caine, E. D. (1996). Relationships of age and Axis I diagnoses in victims of completed suicide: A psychological autopsy study. American Journal of Psychiatry, 153, 1001–1008.

    PubMed  Google Scholar 

  • Conwell, Y., Duberstein, P. R., Cox, C., Herrmann, J. H., Forbes, N. T., & Caine, E. D. (1998). Age differences in behaviors leading to completed suicide. American Journal of Geriatric Psychiatry, 6, 122–126.

    PubMed  Google Scholar 

  • Conwell, Y., Rotenberg, M., & Caine, E. D. (1990). Completed suicide at age 50 and over. Journal of the American Geriatrics Society, 38, 640–644.

    PubMed  Google Scholar 

  • Draper, B. (1994). Suicidal behaviour in the elderly. International Journal of Geriatric Psychiatry, 9, 665–661.

    Google Scholar 

  • Gallagher-Thompson, D., McKibbin, C., Koonce-Volwiler, D., Menendez, A., Stewart, D., Thompson, L. W., et al. (2000). Psychotherapy with older adults. In C. R. Snyder & R. E. Ingran (Eds.), Handbook of psychological change: Psychotherapy processes and practices for the 21st century (pp. 614–637). New York: John Wiley & Sons.

    Google Scholar 

  • Garand, L., Mitchell, A. M., Dietrick, A., Hijjawi, S. P., & Pan, D. (2006). Suicide in older adults: Nursing assessment of suicide risk. Issues in Mental Health Nursing, 27, 355–370.

    Article  PubMed  Google Scholar 

  • Jarvik, L. F., Mintz, J., Steuer, J., & Gerner, R. (1982). Treating geriatric depression: A 26-week interim analysis. Journal of the American Geriatric Society, 30, 713–717.

    Google Scholar 

  • Johansson, L. M., Sundquist, J., Johansson, S. E., Qvist, J., & Bergman, B. (1997). The influence of ethnicity and social and demographic factors on Swedish suicide rates. A four year follow-up study. Social Psychiatry and Psychiatric Epidemiology, 32, 165–170.

    PubMed  Google Scholar 

  • Lynch, T. R., Mendelson, T., Robins, C. J., Krishnan, R., Ranga, K., George, L. K., et al. (1999). Perceived social support among depressed elderly, middle-aged, and young-adult samples: Cross-sectional and longitudinal analyses. Journal of Affective Disorders, 55, 159–170.

    Article  PubMed  Google Scholar 

  • Mireault, M., & de Man, A. F. (1996). Suicidal ideation among the elderly: Personal variables, stress and social support. Social Behavior and Personality, 24, 385–392.

    Article  Google Scholar 

  • Montano, C. B. (1999). Primary care issues related to the treatment of depression in elderly patients. Journal of Clinical Psychiatry, 60(Suppl. 20), 45–51.

    PubMed  Google Scholar 

  • Pearson, J. L., & Brown, G. K. (2000). Suicide prevention in late life: Directions for science and practice. Clinical Psychology Review, 20(6), 685–705.

    Article  PubMed  Google Scholar 

  • Pearson, J. L., Conwell, Y., & Lyness, J. M. (1997). Late-life suicide and depression in the primary care setting. In L. S. Schneider (Ed.), Developments in geriatric psychiatry: New directions for mental heath services, (No. 76, pp. 13–38). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Purcell, D., Thrush, C. R. N., & Blanchette, P. L. (1999). Suicide among the elderly in Honolulu County: A multiethnic comparative study (1987–1992). International Psychogeriatrics, 11, 57–66.

    Article  PubMed  Google Scholar 

  • Rifai, A. H., George, C. J., Stack, J. A., Mann, J. J., & Reynolds, C. F., III. (1994). Hopelessness in suicide attempters after acute treatment of major depression in late life. American Journal of Psychiatry, 151, 1687–1690.

    PubMed  Google Scholar 

  • Rubenowitz, E., Waern, M., Wilhelmson, K., & Allebeck, P. (2001). Life events and psychosocial factors in elderly suicides: A case-control study. Psychological Medicine, 31, 1193–1202.

    Article  PubMed  Google Scholar 

  • Rutz, W., Walinder, J., Von Knorring, L., Rihmer, Z., & Philgren, H. (1997). Prevention of depression and suicide by education and medication: Impact on male suicidality. An update from the Gotland study. International Journal of Psychiatry in Clinical Practice, 1, 39–46.

    Article  Google Scholar 

  • Shenassa, E. D., Rogers, M. L., Spalding, K. L., Roberts, M. B. (2004). Safer storage of firearms at home and risk of suicide: A study of protective factors in a nationally representative sample. Journal of Epidemiology and Community Health, 58, 841–848.

    Article  PubMed  Google Scholar 

  • Steuer, J. L., Mintz, J., Hammen, C. L., Hill, M. A., Jarvik, L. F., McCarley, T., et al. (1984). Cognitive-behavioral and psychodynamic group psychotherapy in treatment of geriatric depression. Journal of Consulting and Clinical Psychology, 52, 180–189.

    Article  PubMed  Google Scholar 

  • Szanto, K., Gildengers, A., Mulsant, B. H., Brown, G. K., Alexopoulos, G. S., & Reynolds, C. F. (2002). Identification of suicide ideation and prevention of suicidal behavior in the elderly. Drugs and Aging, 19, 11–24.

    Article  PubMed  Google Scholar 

  • Szanto, K., Reynolds, C. F., Conwell, Y., Begley, A. E., & Houck, P. (1998). High levels of hopelessness persist in geriatric patients with remitted depression and a history of attempted suicide. Journal of the American Geriatrics Society, 46, 1401–1406.

    PubMed  Google Scholar 

  • Thompson, L. W., Coon, D. W., Gallagher-Thompson, D., Sommer, B. R., & Koin, D. (2001). Comparison of desipramine and cognitive-behavioral therapy in the treatment of elderly outpatients with mild-to-moderate depression. American Journal of Geriatric Psychiatry, 9, 225–240.

    PubMed  Google Scholar 

  • Thompson, L. W., Gallagher, D., & Breckenridge, J. S. (1987). Comparative effectiveness of psychotherapies for depressed elders. Journal of Consulting and Clinical Psychology, 55, 385–390.

    Article  PubMed  Google Scholar 

  • Turvey, C. L., Conwell, Y., Jones, M. P., Phillips, C., Simonsick, E., Pearson, J. L., et al. (2002). Risk factors for late-life suicide: A prospective community-based study. American Journal of Geriatric Psychiatry, 10, 398–406.

    PubMed  Google Scholar 

  • Uncapher, H., Gallagher-Thompson, D., Osgood, N. J., & Bonger, B. (1998). Hopelessness and suicide ideation in older adults. Gerontologist, 38, 62–70.

    PubMed  Google Scholar 

  • Waern, M., Besko, J., Runeson, B., & Skoog, I. (1999). Suicidal feelings in the last year of life in elderly people who commit suicide. Lancet, 334, 917–918.

    Article  Google Scholar 

  • Wen-Hung, K., Gallo, J. J., & Eaton, W. W. (2004). Hopelessness, depression substance disorder, and suicidality: A community based study. Social Psychiatry and Psychiatric Epidemiology, 39, 497–501.

    Google Scholar 

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Brown, G.K., Brown, L.M., Bhar, S.S., Beck, A.T. (2008). Cognitive Therapy for Suicidal Older Adults. In: Gallagher-Thompson, D., Steffen, A.M., Thompson, L.W. (eds) Handbook of Behavioral and Cognitive Therapies with Older Adults. Springer, New York, NY. https://doi.org/10.1007/978-0-387-72007-4_9

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