Depression in older women who died by suicide: associations with other suicide contributors and suicide methods

Abstract

Suicides among older women have received little research attention. In this study based on the 2017–2019 National Violent Death Reporting System data, we examined the prevalence of depression in older female suicide decedents (N = 3,061), associations between depression and other suicide precipitants, and the associations between suicide methods and depression. Descriptive statistics and generalized linear models (GLM) for a Poisson distribution with a log link were used to examine the research questions. Of the decedents, 15.0% had depressed mood without a reported diagnosis and 41.8% had a depression diagnosis. Nearly one-half of the decedents with reported depression were receiving mental health/substance use treatment at the time of injury. The likelihood of depression was lower among those who were age 85 and older compared to those were age 65–74, but higher among those who had anxiety disorder (IRR = 1.50, 95% CI = 1.33–1.69), history of suicidal ideation (IRR = 1.22, 95% CI = 1.10–1.35), history of suicide attempt (IRR = 1.27, 95% CI = 1.14–1.41), and bereavement problems (IRR = 1.45, 95% CI = 1.27–1.65). Those who had depression were less likely to have used firearms (IRR = 0.85, 95% CI = 0.75–0.97) but more likely to have used hanging/suffocation (IRR = 1.37, 95% CI = 1.13–1.67). The findings show that gun ownership was likely an important factor for firearm use. The high prevalence of depressed mood and/or depression diagnosis among older female suicide decedents at the time of their fatal injury underscores the importance of assessing depression and providing evidence-based depression treatment as an essential suicide prevention approach.

Keywords:

• Anxiety disorder
• depression
• firearms
• poisoning
• suicide
• suicide attempt

Acknowledgments

The Centers for Disease Control and Prevention (CDC) administers the National Violent Death Reporting System (NVDRS) in conjunction with participating NVDRS states. CDC provided the NVDRS Restricted Access Data used in this study to the authors. Study findings and conclusions are those of the authors alone and do not necessarily represent the official position of CDC or of the participating NVDRS states.

Ethics statement

This study based on de-identified/deceased individuals was exempt from the authors’ Institutional Review Board’s review.

Author contributions

Namkee G. Choi: Conceptualization; Data curation; Formal analysis; Investigation; Original draft; and Funding acquisition C. Nathan Marti: Methodology; and Review & editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The Centers for Disease Control and Prevention (CDC) administers the National Violent Death Reporting System (NVDRS) in conjunction with participating NVDRS states. CDC provided the NVDRS Restricted Access Data used in this study to the authors after reviewing the authors’ data request. Study findings and conclusions are those of the authors alone and do not necessarily represent the official position of CDC or of the participating NVDRS states.

Additional information

Funding

This work was supported by the National Institute on Aging [P30AG066614], awarded to the Center on Aging and Population Sciences at The University of Texas at Austin.