Elderly Suicide in Hong Kong ???????????

1
Elderly Suicide in Hong Kong???????????

• Prof. Helen Chiu ?????
• Head, Department of Psychiatry ???????
• Faculty of Medicine ???
• The Chinese University of Hong Kong ??????

2
Trend in Suicide Rates (by Age Groups) from
1990-2005????? (????? ) 1990-2005
Census and Statistics Dept of HKSAR ???????
3
Latest official suicide statistics
(2005)?????????? (2005)
4
Suicide in Elderly???????

• Elderly suicide rates 2 to 3 times rates in
  younger adults in Hong Kong
• ??????????????2?3?
• Elderly suicide rates tend to be high in Asian
  countries despite traditional veneration of the
  elderly
• ???????????, ???????????
• Few studies on elderly suicide in Hong Kong and
  Asia
• ???????????????????

5
Suicide Rates (per 100,000) by Gender, Age and
Place ??? (? 10???) ???,???????
???WHO,2002
6
Suicide Rates (per 100,000) by Gender, Age and
Place ??? (? 10???) ???,???????
???WHO,2002
7
Attempted Suicide in the elderly (Chiu et al,
1996) ???????

• 55 subjects ? 65 years
• Male Female 11.6
• 40 of cases occurred after 75
• Self-poisoning accounted for over 90 of cases of
  attempted suicide in western studies
• But only 27.3 in our study
• Self-injury --- 72.7

• 55 ??? (??65???)
• ????? 11.6
• 40 ???75???
• ???????,??????????90
• ????????27.3
• ?? 72.2

8

• 49.1 had depression
• 49.1 ????
• lower than most published data (70-90)
• ????????????? (70-90)
• 36 no psychiatric diagnosis
• 36 ????????

9

• FU for 2 to 4 years ---
• 2 ? 4?????
• Repetition rate of 3.6 is low compared with
  previous studies in western countries (around 8
  to 20)
• ????????(??8?20) ???,?3.6??????
• Rate of completed suicide --- 5.5
• ????? --- 5.5
• Rates of 2-8 in studies in western countries
• ???????????2-8

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Psychological Autopsy Study??????

• retrospective study of elderly suicide by
• interviewing informants
• ???????????????
• case control study
• ???????
• identify risk factors
• ??????

11
Psychological Autopsy Study (Chiu et al, 2004)
??????

• 70 ?????
• 100???????
• ?? ? 60
• ???
• 87??????9??????????,?????
• 60???????????????????

• 70 suicide cases
• 100 community control elderly
• age ? 60
• Results
• 87 of suicide cases had a mental disorder
  compared to 9 of controls, in particular
  depressive illness
• 60 of suicide subjects had expressed suicidal
  intention before suicide

12
Psychological Autopsy Study??????

• Results
• 75 of suicide subjects had consulted a doctor
  within 1 month of death compared with 39 of
  control
• ?39????????,75???????1?????????
• Suicide cases -- ?negative life events, ?no. of
  physical illness, ?cancer, ?pain, ?past hx of
  attempted suicide
• ???? ????
• ??????,?????, ??,??,?????

13
Suicidal attempts in the elderly (Tsoh et al,
2005)??????

• 66 suicide attempters 66?????????
• 91 subjects from community 91?????????
• 68.2 of suicide attempters had major depression
• 68.2 ????????????????
• Major depression associated with 60-fold
  increased risk for attempted suicide
• ?????????????????????60?
• Past suicidal attempts, poor ADL, arthritis, low
  conscientiousness ? risk
• ????,??????,?????,?????????
• Co-residence with children ? risk
• ??????????

14
Clues to suicide prevention in HK(Chiu et al,
1996 2004 Tsoh et al, 2005)?????????

• Psychiatric illness, esp. depression is an
  important risk factor of suicide
• ??? ,??????????????????
• Attention should be paid to those with past
  suicidal attempt and those expressing suicidal
  ideas
• ????????????????????????
• Poor health and pain ? suicide risk
• ???????????????
• Primary care doctors may be gate keepers to
  detect suicidal elderly
• ????????????????

15
SARS and Elderly Suicide in Hong
Kong?????????????

• (Chan et al, 2006)

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(No Transcript)
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Surveillance data on rate of completed
suicide??????????
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SARS and Elderly Suicide (Chan et al, 2006)
??????????

• There is an apparent increase in
• suicide rates in older persons in
• 2003, which may be related to
• SARS outbreak
• Older people may be more
• vulnerable
• disruption of health care
• disruption of social network and support
• proneness to exaggerated pessimism because of
  high mortality of SARS in older persons

• ?2003?,????????
• ??????,????
• ??????????
• ?????????
• ???????
• ??????????
• ??????,????????????????