Suicidal ideation in older adults : applicability of the interpersonal theory of suicide

Abstract

More than 800,000 people worldwide commit suicide every year. In Hong Kong, the suicide rate among the elderly is highest among all age groups. A better understanding of the factors that influence suicide risk in general and also those specific to the elderly is needed to make suicide assessment and interventions more effective and efficient. Previous research studies have found depression and hopelessness to be robust indicators for suicide, but in recent years social correlates of suicide have received much attention under the theoretical framework of the Interpersonal Theory of Suicidal Behaviour. The predictive power of traditional risk factors compared to those of the IPTS constructs is an issue that has important clinical implications for suicide assessment and intervention. This study examined the effects of the IPTS constructs on suicidal ideation beyond the influence of hopelessness and depression in a sample of Chinese elderly living in Hong Kong. Results indicated that hopelessness and depression significantly predicted suicidal ideation. Some interpersonal variables proposed by the IPTS were significant indicators for suicide risk, but not beyond the influence of hopelessness and depression. Depression and hopelessness mediated the relationship between IPTS constructs and suicidal ideation. This suggests that depression and hopelessness are more proximal predictors of suicidal ideation than the IPTS constructs. Interpersonal variables play a role, but may not necessarily supersede hopelessness and depression, in the prediction of suicidal risk. Further investigations are needed to explore how different suicide risk factors contribute to pathways to suicide in integrated models.