Magazine article Clinical Psychiatry News

Poor Sleep Linked to Suicide in Older Patients

Magazine article Clinical Psychiatry News

Poor Sleep Linked to Suicide in Older Patients

Article excerpt

FROM JAMA PSYCHIATRY

Elderly patients who report poor sleep quality face a significantly increased risk of suicide for up to a decade, whether or not depression is also present.

Even after controlling for comorbid depression, investigators found that impaired sleep was associated with a 20% increased risk of suicide in these patients.

Results of the prospective observational study suggest that regularly asking about sleep quality might help improve suicide risk assessment, Rebecca A. Bernert, Ph.D., and her colleagues reported online Aug. 13 in JAMA Psychiatry (doi: 10.1001/jamapsychiatry.2014.1126).

Older adults tend to seek more physician care in the final weeks and months before a suicide than do other at-risk populations (73% and 45%, respectively).

"Furthermore, at least one psychological autopsy study indicates that disturbed sleep is visible to friends and family members in the weeks and months preceding death," wrote Dr. Bernert of Stanford (Calif.) University and her coauthors. "Targeting disturbed sleep as a visible warning sign of suicide may, in this way, constitute a novel opportunity for improved risk detection; this more narrowed, demographic focus may specifically inform intervention among a group at heightened risk for suicide."

The cohort comprised 420 subjects who were a subpopulation of the Established Populations for Epidemiologic Studies of the Elderly study. This project followed 14,500 older adults from 1981 to 1993; its purpose was to identify predictors of mortality, hospitalization, and placement in long-term care facilities and to investigate risk factors for chronic diseases and loss of function.

From this group, 400 controls were matched to 20 subjects who had committed suicide.

Sleep was evaluated with a five-item Sleep Quality Index (SQI) constructed by the investigators. …

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