Suicidal ideation in relation with age

The present study tested the hypothesis that suicidal ideation varies with age.259 suicide notes were analysed. This represented all of the suicide notes written by individuals who committed suicide during a 3-year period who resided in the 34 moderately advantaged natural communities of Los Angeles County. The method of analysis involved categorizing each note according to a scheme of five general categories: (a) Addressee, (6) Reasons Stated, (c) Affect Indicated, (d) Specific Content, and (e) General Focus of Note. The notes were divided into four age groups20-39, 40-49, 50-59, and 60 and over, and compared with reference to the five general categories. Differences between age groups were found significant at the .05 level for Categories b and e. Specific items within each category were discussed when such items were found statistically more or less often in the notes of one age group than in the notes of the other age groups. Suggestions for treatment and prevention of suicide were offered. The problems which seem to overwhelm the young adults (20-39) more frequently than the older individuals were related to feelings of rejection and especially problems concerning heterosexual love objects and competition for them. There is a notable absence of reasons related to illness and pain. They could probably cope with the world physically but seemed unable to cope with their problems concerning interpersonal relations, and some of the deeper psychic problems related to sexual needs. At their dying moments these people seemed both willing and able to express affect in their suicide notes. A closer look at this affect indicates it is primarily the internalization of blame and guilt and selfdepreciation. At the same time they express love and praise for others.

Seeking forgiveness from the deity was less frequent in their notes than in the notes of older suicides. Suicide prevention with this type of individual might be best accomplished through dynamic psychotherapy. This could help the individual gain insight into feelings which stem from early object relationships and which precipitate his recurrent interpersonal problems.

Male gender (Hawtons), firearms, substance use, mental disorders, depression, and past attempts as contributing factors to suicide completion

Among adolescents, suicide is the third leading cause of death nationally, but in New Mexico it is the second leading cause of death.

possible contributing factors such as depression, previous attempts, and alcohol and drug use.

Suicide deaths resulted primarily from firearms (67%), hanging (16%), poisoning (6%), inhalation (4%), and other methods (7%).

As predicted, male adolescent suicide death rates were significantly higher than female rates.

higher among adolescents than other ages [New Mexico Department of Health, 1996].

Firearms were used by a majority of individuals in this study. It is possible that firearms are more accessible by adolescents in New Mexico than in some other parts of the U.S.

Mental health problems were present in a large proportion of individuals who completed suicide. Depression was the most common mental health problem noted in our study,

Alcohol and/or other drug use was a factor in half of suicide deaths; The use of alcohol and other substances can result in impaired judgment and reduced inhibitions.

Training physicians to identify signs of depression has been shown to be successful in reducing suicide death rates. The unique patient-physician relationship allows this opportunity for intervention. Funding continuing education in this area may provide a valuable resource to the community.

Higher youth suicidal rates for gays, lesbians, and bisexuals (GENDER)

Both clinical and epidemiological literature point to elevated rates of suicidal behaviors in gay, lesbian, and bisexual youth (GLBY). Recent North American and New Zealand studies of large populations (especially the US Youth Risk Behavior Surveys from several states) indicate that gay, lesbian, and bisexual adolescents (males in particular) can have rates of serious suicide attempts at least four times those of apparently heterosexual youth. There are various reasons why this figure is likely to be an underestimate. Reasons for these elevated rates of suicidal behavior include a climate of homophobic persecution in schools, and sometimes in family and communityvalues and actions that stigmatize homosexuality and that the youth who has not yet "come out has to endure in silence. American research identifies several types of stress associated with an emerging gay and lesbian identity: personal feelings of self-doubt in those who have no help or support network; loss of peers, emotional denigration and physical harassment in those whose sexual orientation is known in school; and family rejection of youth who have identified themselves as gay or lesbian. Substance abuse is very much higher in youth denigrated in school settings, and they are likely to skip school frequently or drop out altogetherand may be pulled into subcultures of drug use,

promiscuity, and prostitution, where suicidal intent may also be acted out by contracting HIV [Seal et al., 2000; Tompkins-Rosenblatt, 1997]. Many of these factors are known to be associated with higher rates of suicidal behavior [Remafedi, 1999].