Zusammenfassung
Allgemeine Modelle zur Entstehung suizidalen Verhaltens können die überproportionale Betroffenheit alter Menschen nur unzureichend erklären. Das hier vorgestellte transaktionale Modell versucht, die komplexen Bedingungen suizidaler Handlungen im Alter darzustellen. Diskutiert wird eine vielfache reziproke Abhängigkeit von biologischen, psychologischen und sozialen Faktoren, die suizidales Verhalten i.S. eines Problemlöseverhaltens erleichtern können.
Abstract
General theories of suicidology are insufficient to explain the overproportional rate of suicidal behaviour in the elderly. The proposed transactional model represents a bio-psycho-social foundation of suicidal behavior in the elderly. The reciprocal interactions of biological, somatic, psychological and social factors in old age which may enhance suicidal behavior as a mode of problem-solving behavior are discussed.
Literatur
Abrams RC, Bromberg CE (2006) Personality disorders in the elderly: a flagging field of inquiry. Int J Geriatr Psych 21:1013–1017
Abrams RC, Horowitz SV (1999) Personality disorders after age 50: a meta-analytic review of the literature. In: Rosowski E, Abrams RC, Zweig RA (eds) Personality disorders in older adults. Erlbaum, Mahwah pp 55–68
Achté K (1988) Suicidal tendencies in the elderly. Suicide Life-Threat Behav 18(1): 55–65
Achterberg W, Pot AM, Kerkstra A et al (2006) Depressive symptoms in newly admitted nursing home residents. Int J Geriatr Psych 21:1156–1162
Anger H (1977) Sozialpsychologische Aspekte des Suizids im Alter. Thieme, Stuttgart
Artero S, Astruc B, Courtet P et al (2006) Life-time history of suicide attempts and coronary artery disease in a community-dwelling elderly population. Int J Geriatr Psych 21:108–112
Bandura A (1978) The self system in reciprocal determinism. Am Psychol 33:344–358
Barak Y, Aizenberg D (2006) Association between antidepressant prescribing and suicide in Israel. Int Clin Psychopharm 21(5):281–284
Barnow S, Linden M (2000) Epidemiology and psychiatric morbidity of suicidal ideation among the elderly. Crisis 21:171–180
Barnow S, Linden M, Freyberger HJ (2004) The relation between suicidal feelings and mental disorders in the elderly: results from the Berlin Aging Study (BASE). Psychol Med 34:741–746
Blay SL, Andreoli SB, Dewey ME et al (2007) Co-occurrence of chronic physical pain and psychiatric morbidity in a community sample of older people. Int J Geriatr Psych (in press)
Bruce ML (2002) Psychosocial risk factors for depressive disorders in late life. Biol Psychiat 52:175–184
Burkhardt H, Wehling M, Gladisch R (2007) Prävention unerwünschter Arzneimittelwirkungen bei älteren Patienten. Z Gerontol Geriatr 40:241–254
Conwell Y, Duberstein PR, Herrmann JH et al (1996) Relationship of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiat 153:1001–1008
Draper B (1996) Attempted suicide in old age. Int J Geriatr Psych 11:577–587
Duberstein PR, Conwell Y, Caine ED (1994) Age differences in the personality characteristics of suicide completers: preliminary findings from a psychological autopsy study. Psychiat 57:213–224
Duberstein PR, Conwell Y, Conner KR et al (2004a) Suicide at 50 years of age and older: perceived physical illness, family discord and financial strain. Psychol Med 34:137–146
Duberstein PR, Conwell Y, Conner KR et al (2004 b) Poor social integration and suicide: fact or artifact? A case-control study. Psychol Med 34:1331–1337
Eddington C, Piper J, Tanna B et al (1990) Relationships between happiness, behavioural status and dependency on others in elderly patients. Brit J Clin Psychol 29:43–50
Eddleston M, Dissanayake M, Sheriff MH et al (2006) Physical vulnerability and fatal self-harm in the elderly. Brit J Psychiat 189:278–279
Engels GI, Duijsens IJ, Haringsma R et al (2003) Personality disorders in the elderly compared to four younger age groups: a cross-sectional study of community residents and mental health patients. J Pers Disord 17:447–459
Farrell M, Gibson S (2007) Age interacts with stimulus frequency in the temporal summation of pain. Pain Med 8(6):514–520
Fekete S, Schmidtke A, Etzersdorfer E et al (1998) Media reports in Hungary, Austria, Germany and Lithuania in 1981 and 1991. Reflection, mediation and changes of sociocultural attitudes towards suicide in the mass media. In: De Leo D, Schmidtke A, Diekstra RFW (eds) Suicide prevention – a holistic approach. Kluwer, Dordrech, pp 145–156
Ferring D, Filipp SH (1999) Soziale Netze im Alter: Selektivität in der Netzwerkgestaltung, wahrgenommene Qualität der Sozialbeziehungen und Affekt. Z Entwickl Päd 31(3):127–137
Fortin A, Lapierre S, Baillargeon J et al (2001) Suicidal ideation and self-determination in institutionalized elderly. Crisis 22(1):15–19
Gagliese L (2007) What do experimental pain models tell us about aging and clinical pain? Pain Med 8(6):475–477
Givens JL, Datto CJ, Ruckdeschel K et al (2006) Older patients' aversion to antidepressants. A qualitative study. J Gen Intern Med 21(2):146–151
Gutmann D (1985) The parental imperative revisited. In: Meacham J (ed) Family and individual development. Karger, Basel, pp 31–60
Hagenbuchner K (1967) Der Selbstmord des alten Menschen. Materia medica Nordmark, Wiss Beibl Nr 58
Harwood D, Hawton K, Hope T et al (2001) Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case-control study. Int J Geriatr Psych 16:155–165
Hirzel-Wille M (2002) Suizidalität im Alter. In: Boothe B, Volkart R (eds) Psychoanalyse im Dialog (Vol 11). Peter Lang, Bern
Inoue K, Tanii H, Abe S et al (2007) Suicidal tendencies among the elderly in Mie Prefecture. Japan, between 1996 and 2002. Legal Med 9(3):134–138
Klostermann P, Schneider V (2004) „So ist kein Leben“ – Suizide alter und hochaltriger Menschen. Suizidprophylaxe 31:35–40
Krueger KR, Wilson RS, Shah R et al (2006) Personality and incident disability in older persons. Age Ageing 35:428–433
Kruse A (1997) Psychosoziale Einflussfaktoren depressiver Symptome im Alter. In: Radebold H, Hirsch RD, Kipp J, Kortus R, Stoppe G, Struwe B, Wächtler C (eds) Depressionen im Alter. Steinkopff, Darmstadt, pp 18–32
Kruse A, Gaber E, Heuft G et al (2002) Gesundheit im Alter (Heft 10). Robert-Koch-Institut, Berlin
Lanzieri G (2006) Langfristige Bevölkerungsvorausschätzungen auf nationaler Ebene (= Statistik kurzgefasst: Bevölkerung und soziale Bedingungen, Report 3). Eurostat, Luxembourg
Lautenschlager NT, Förstl H (2007) Personality change in old age. Curr Opin Psychiatr 20:62–66
Leistner K, Meier-Baumgartner H-P, Pientka L (2002) Hamburger Erklärung. Z Gerontol Geriatr 35:50–53
Lim WS, Rubin EH, Coats M et al (2005) Alzheimer disease represents increased suicidal risk in relation to later stages. Alz Dis Assoc Dis 19:214–221
McLaren S, Gomez R, Bailey M et al (2007) The association of depression and sense of belonging with suicidal ideation among older adults: applicability of resiliency models. Suicide Life-Threat Behav 37(1):89–102
Mehta M, Whyte E, Lenze E et al (2007) Depressive symptoms in late life: associations with apathy, resilience and disability vary between young-old and old-old. Int J Geriatr Psych DOI:10.1002/gps
Meltzer CC, Smith G, DeKosky ST et al (1998) Serotonin in aging, late-life depression, and Alzheimer's disease: the emerging role of functional imaging. Neuropsychopharmacol 18:407–430
Möller-Leimkühler AM (2002) Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disorders 71(1–3):1–9
Oyama H, Ono Y, Watanabe N et al (2006) Local community intervention through depression screening and group activity for elderly suicide prevention. Psychiat Clin Neuros 60:110–114
Peisah C, Snowdon J, Gorrie C et al (2007) Investigation of Alzheimer's disease-related pathology in community dwelling older subjects who committed suicide. J Affect Disorders 99:127–132
Roberts BW, DelVecchio WF (2000) The rank-order consistency of personality traits from childhood to old age: A quantitative review of longitudinal studies. Psychol Bull 126:3–25
Rutz W (1999) Improvement of care for people suffering from depression: the need for comprehensive education. Int Clin Psychopharm 14 (Suppl 3):27–33
Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen (2000/2001) Bedarfsgerechtigkeit und Wirtschaftlichkeit. III. Über-, Unter- und Fehlversorgung, Bonn
Schaller S (1997) Anomie und suizidal-depressive Tendenzen im Alter. In: Radebold H, Hirsch RD, Kipp J (eds) Depressionen im Alter. Steinkopff, Darmstadt pp 140–141
Schmidtke A, Bille-Brahe U, DeLeo D et al (2004) Suicide and suicide attempt in Europe – an overview. In: Schmidtke A, Bille-Brahe U, De Leo D, Kerkhof A (eds) Suicidal behaviour in Europe – Results from the WHO/EURO Multicentre Study on Suicidal Behaviour. Hogrefe, Göttingen, pp 15–28
Schröder C, Schmutzer G, Klaiberg A et al (2003) Ärztliche Sterbehilfe im Spannungsfeld zwischen Zustimmung zur Freigabe und persönlicher Inanspruchnahme – Ergebnisse einer repräsentativen Befragung der deutschen Bevölkerung. Psychother Psych Med 53:334–343
Sorock GS, Chen LH, Gonzalgo SR et al (2006) Alcohol-drinking history and fatal injury in older adults. Alcohol 40(3):193–199
Srivastava S, John OP, Gosling SD et al (2003) Development of personality in early and middle adulthood: set like plaster or persistent change? J Pers Soc Psychol 84:1041–1053
Steunenberg B, Twisk JWR, Beekman ATF et al (2005) Stability and change of neuroticism in aging. J Gerontol 60B:27–33
Tadros G, Salib E (2006) Elderly suicide in primary care. Int J Geriatr Psych (im Druck DOI: 10.1002/gps.1734)
Tesch-Römer C, Engstler H, Wurm S (eds) (2006) Altwerden in Deutschland. VS-Verlag, Wiesbaden
Thomas AJ, Hendriksen M, Piggott M et al (2006) A study of the serotonin transporter in the prefrontal cortex in late-life depression and Alzheimer's disease with and without depression. Neuropath Appl Neuro 32:296–303
Thomas AJ, Kalaria RN, O'Brien JT (2004) Depression and vascular disease: what is the relationship? J Affect Disorders 79:81–95
Van Alphen SP, Engelen GJJA, Kuin Y et al (2006) The relevance of a geriatric sub-classification of personality disorders in the DSM-V. Int J Geriatr Psych 21:205–209
Van der Wal G, Van Eijk JThM, Leenen HJJ et al (1992) Euthanasia and assisted suicide. II. Do Dutch family doctors act prudently. Fam Practice 9:135–140
Waern M, Runeson BS, Allebeck P et al (2002) Mental disorder in elderly suicides: a case-control study. Am J Psychiat 159:450–455
Wei W, Sambamoorthi U, Olfson M et al (2005) Use of psychotherapy for depression in older adults. Am J Psychiat 162:711–717
Wilson RS, Krueger KR, Arnold SE et al (2006) Childhood adversity and psychosocial adjustment in old age. Am J Geriat Psychiat 14:307–315
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Schaller, S. Multimodales Erklärungsmodell der Suizidalität im Alter. Z Gerontol Geriat 41, 14–21 (2008). https://doi.org/10.1007/s00391-008-0518-y
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DOI: https://doi.org/10.1007/s00391-008-0518-y