Suicide in later life: a comparison between cases with early-onset and late-onset XXXX .

@entity1 @entity308 @entity146 @entity167 @entity204
BACKGROUND: Suicide rates are high in elderly @entity1 with @entity308 . We compared behavioural, clinical and care characteristics of @entity308 elderly @entity1 , aged 60years and over at the time of @entity204 by suicide, with an early-onset @entity308 (EOD, onset before 60years) with those @entity1 with a late age of onset (LOD). METHOD: From a 10-year national clinical survey of all suicides in England and Wales (n=13066) we identified 549 LOD cases, and 290 EOD cases. EOD and LOD cases were compared by logistic regression adjusted for age at suicide. RESULTS: Method of suicide did not differ by age of onset of @entity308 . LOD cases were significantly less likely to have a history of @entity146 admissions (OR=0.2 [0.1-0.3]), @entity167 misuse (OR=0.6 [0.4-0.9]) and self-harm (0.6 [0.4-0.8]). LOD cases also had a lower prevalence of a @entity146 co-morbid diagnosis (0.6 [0.4-0.7]) and a lower prescription rate for psychotropic drugs other than antidepressants. Furthermore, the number of recent life-events was significantly higher (OR=1.4 [1.0-1.9]) in LOD while the frequency of recent self-harm was similar to EOD. CONCLUSION: Although our study suggests that psychopathology of suicide among elderly @entity308 @entity1 differs between EOD and LOD, the final pathway (via recent self-harm) to suicide may be similar in up to a quarter of @entity1 in both groups. Our results suggest that strategies to enhance coping abilities and provision of support to negate the effects of life-events might be especially important in the prevention of suicide in LOD.
