Predictors of Passive and Active Suicidal Ideation and Suicide Attempt Among Older People: A Study in Tertiary Care Settings in Thailand

Figures & data

Table 1 Demographic Data of Respondent Patients

Characteristics	All (n=803) n (%)	Passive Suicidal Ideation				Active Suicidal Ideation				Suicidal Attempt
		Yes 164 (20.42)	No 635 (79.08)	Statistic Difference (X^2, t)	P	Yes 30 (3.74)	No 770 (95.89)	Statistic Difference (X^2, t)	P	Yes 19 (2.37)	No 783 (97.51)	Statistic Difference (X^2, t)	P
Age, Mean ± SD (min-max)	69.24 ± 6.90 (60–89)	70.36 ± 7.43	68.94 ± 6.69	2.221	0.027	68.83 ± 6.98	69.27 ± 6.89	−0.335	0.740	66 ± 3.71	69.33 ± 6.92	−3.698	0.001
Female	560 (69.74)	123 (75.00)	434 (68.30)	2.733	0.058	25 (83.33)	533 (69.20)	2.726	0.069	17 (89.50)	542 (69.20)	3.603	0.042
Education				14.904	<0.001			4.286	0.027			0.344	0.371
More than 6 years	305 (37.98)	41 (25.00)	263 (41.40)			6 (20.00)	298 (38.70)			6 (31.60)	299 (38.02)
6 years and less	498 (62.02)	123 (75.00)	372 (58.60)			24 (80.00)	472 (61.30)			13 (68.40)	484 (61.80)
Marital status				12.026	<0.001			4.096	0.251			3.891	0.274
living alone	293 (36.50)	79 (48.20)	213 (33.50)			14 (46.70)	279 (36.20)			6 (31.60)	288 (36.80)
Living together	509 (63.50)	85 (51.80)	422 (66.50)			16 (53.30)	491 (63.80)			13 (68.40)	495 (63.20)
Income (USD/month)				25.730	<0.001			4.292	0.027			1.882	0.127
0–160	469 (59.40)	124 (75.60)	342 (53.90)			23 (76.70)	444 (57.70)			14 (73.70)	454 (58.00)
≥161	320 (40.60)	40 (24.40)	293 (46.10)			7 (23.30)	326 (42.30)			5 (26.30)	329 (42.00)
Family psychiatric history
Mood disorder	18 (2.24)	3 (1.80)	15 (2.40)	0.160	0.482	1 (3.30)	17 (2.20)	0.165	0.502	1 (5.30)	17 (2.20)	0.806	0.354
Alcohol use disorder	17 (2.12)	5 (3.10)	12 (1.90)	0.863	0.255	1 (3.30)	16 (2.10)	0.218	0.482	3 (15.80)	14 (1.80)	17.500	0.006
Cognitive disorder	6 (0.75)	2 (1.20)	4 (0.60)	0.620	0.355	0(0)	6 (0.80)	0.236	0.794	1 (5.30)	5 (0.60)	5.334	0.135
Underlying disease
Hypertension	205 (25.50)	22 (13.40)	182 (28.70)	15.936	<0.001	2 (6.70)	202 (26.20)	5.819	0.008	0 (0)	205 (26.20)	6.683	0.003
Diabetes mellitus	53 (6.60)	10 (6.10)	43 (6.80)	0.096	0.459	1 (3.30)	52 (6.80)	0.546	0.395	1 (5.30)	52 (6.60)	0.057	0.639
Dyslipidemia	61 (7.60)	12 (7.30)	49 (7.70)	0.029	0.508	0(0)	61(7.90)	2.573	0.088	0 (0)	61 (7.80)	1.602	0.219
DSM-IV clinical disorder
Past history of depression	40 (4.98)	18 (14.90)	21 (4.10)	19.390	<0.001	7 (25.00)	32 (5.30)	17.808	0.001	7 (41.20)	33 (5.40)	35.712	<0.001
Major depressive disorder	150 (18.67)	79 (48.20)	70 (11.00)	118.554	<0.001	24 (80.00)	125 (16.20)	77.467	<0.001	14 (73.70)	135 (17.20)	39.067	<0.001
Dysthymia	43 (5.35)	17 (10.37)	25 (3.94)	5.349	0.018	4 (13.33)	38 (4.94)	1.436	0.305	1 (5.26)	42 (5.36)	0.331	0.754
Anxiety disorders
Generalized anxiety disorder	54 (6.72)	11 (6.70)	42 (6.60)	0.002	0.541	3 (10.00)	51 (6.60)	0.523	0.330	4 (21.10)	50 (6.40)	6.354	0.033
Panic disorder (current)	15 (1.87)	8 (4.90)	5 (0.80)	13.743	0.001	5 (16.70)	8 (1.00)	44.050	<0.001	1 (5.30)	13 (1.70)	1.400	0.287
Panic disorder (life-time)	14 (1.74)	6 (3.70)	8 (1.30)	4.411	0.047	2 (6.70)	12 (1.60)	4.373	0.094	2 (10.50)	12 (1.50)	8.733	0.041
Agoraphobia	14 (1.74)	11 (6.70)	2 (0.30)	33.500	<0.001	7 (23.30)	6 (0.8)	91.757	<0.001	4 (21.10)	9 (1.20)	46.016	<0.001
Social phobia	3 (0.37)	3 (1.80)	0 (0)	11.731	0.008	1 (3.30)	2 (0.30)	7.291	0.109	1 (5.30)	2 (0.30)	12.465	0.070
Posttraumatic stress disorder	7 (0.87)	5 (3.10)	2 (0.30)	11.302	0.005	3 (10.00)	4 (0.50)	29.880	0.002	1 (5.30)	6 (0.80)	4.328	0.155
Obsessive-compulsive disorder	6 (0.75)	1 (0.60)	5 (0.80)	0.053	0.645	1 (3.30)	5 (0.70)	2.789	0.206	1 (5.30)	5 (0.60)	5.334	0.135
Mixed depressive-anxiety disorder
Mania (past)	6 (0.75)	2 (1.20)	3 (0.50)	1.186	0.271	1 (3.30)	4 (0.50)	3.674	0.175	2 (10.50)	4 (0.50)	25.024	0.008
Mania (current)	6 (0.75)	5 (3.10)	1 (0.20)	14.719	0.002	3 (10.00)	3 (0.40)	35.777	0.001	0 (0)	6 (0.80)	0.147	0.865
Hypomanic (past)	10 (1.25)	3 (1.80)	7 (1.10)	0.571	0.335	2 (6.70)	8 (1.00)	7.396	0.051	1 (5.30)	9 (1.20)	2.544	0.215
Hypomanic (current)	18 (2.24)	11 (6.70)	7 (1.10)	18.754	<0.001	4 (13.30)	14 (1.80)	17.379	0.003	0 (0)	18 (2.30)	0.447	0.646
Alcohol abuse and dependence	10 (1.25)	1 (0.60)	9 (1.42)	0.053	0.645	0 (0)	10 (1.30)	0.236	0.794	0 (0)	6 (0.80)	0.147	0.865
Substance abuse and dependence	3 (0.37)	1 (0.60)	2 (0.30)	0.309	0.497	1 (3.30)	2 (0.30)	7.291	0.109	0 (0)	3 (0.40)	0.073	0.930
MoCA, mean (SD), min-max	16.18 (5.16), 0–30	14.27 (5.01)	16.69 (5.08)	−5.505	<0.001	12.67 (4.7)	16.32 (5.14)	−4.160	<0.001	14.63 (5.27)	16.21 (5.16)	−1.292	0.212
Psychosocial variable, Mean ± SD
MSPSS	58.29 ± 16.54	53.41 ± 17.05	59.67 ± 16.16	−4.177	<0.001	46.07 ± 17.86	58.82 ± 16.32	−3.785	0.001	42.72 ± 14.64	58.69 ± 16.41	−4.559	<0.001
NI	33.79 ± 10.41	41.03 ± 9.81	31.92 ± 9.75	10.365	<0.001	46.61 ± 10.11	33.28 ± 10.12	6.846	<0.001	45.44 ± 10.28	33.53 ± 10.28	4.583	<0.001
TGDS-15	4.71 ± 3.43	7.94 ± 3.65	3.88 ± 2.84	13.088	<0.001	10.07 ± 3.43	4.5 ± 3.26	8.585	<0.001	9.84 ± 4.45	4.58 ± 3.30	5.121	<0.001
CSI anxiety	7.78 ± 2.91	8.91 ± 3.65	7.48 ± 2.60	4.704	<0.001	11.17 ± 4.51	7.64 ± 2.75	4.183	<0.001	10.95 ± 5.36	7.69 ± 2.77	2.638	0.017
T-PSS-10	11.43 ± 7.19	16.11 ± 7.83	10.21 ± 6.50	8.778	<0.001	21.90 ± 7.75	11.01 ± 6.86	7.452	<0.001	20.94 ± 7.96	11.20 ± 7.02	5.145	<0.001

Abbreviations: SD, standard deviation; DSM-IV, diagnostic and statistical manual of mental disorders IV; MoCA, The Montreal Cognitive Assessment; MSPSS, multidimensional scale of perceived social support; NI, The Neuroticism Inventory; TGDS-15, 15-item Thai Geriatric Depression Scale; CSI, The Core Symptom Index; T-PSS, 10-Item Thai Perceived Stress Scale.

Table 2 Logistic Regression Model Predicting Suicidality

Characteristics	Passive Suicidal Ideation vs Control		Active Suicidal Ideation vs Control		Suicide Attempted vs Control
	OR (95% CI)	p	OR (95% CI)	p	OR (95% CI)	p
Age	1.03 (1.00,1.07)	0.069	–	–	0.89 (0.77,1.02)	0.086
Sex	–	–	–	–	1.37 (0.27,1.02)	0.121
Education (Years of study)	1.55 (0.88,2.71)	0.128	1.33 (0.43,4.17)	0.621	–	–
Marital status	0.67 (0.42,1.08)	0.098	–	–	–	–
Hypertension	0.51 (0.28,0.93)	0.028	0.22 (0.04,1.30)	0.094	0.06 (0.00,2.42)	0.135
Family history of alcohol use disorder	–	–	–	–	17.56 (2.76,111.46)	0.002
Past history of depression	1.11 (0.50,2.55)	0.813	0.93 (0.25,3.48)	0.909	2.76 (0.67,11.45)	0.158
Major depressive disorder	2.06 (1.17,3.61)	0.012	3.74 (1.10,12.74)	0.035	1.10 (0.14,8.89)	0.928
Generalized anxiety disorder	–	–	–	–	1.06 (0.22,5.20)	0.859
Panic disorder (current)	1.57 (0.22,10.91)	0.650	1.71 (0.23,12.62)	0.597	–	–
Panic disorder (life-time)	1.58 (0.24,10.32)	0.635	-	-	0.31 (0.01,9.17)	0.505
Agoraphobia	3.87 (0.75,19.91)	0.106	16.45 (2.84,95.19)	0.002	62.28 (4.86,796.63)	0.001
Social phobia	13.57 (0.51,358.93)	0.119	-	-	-	-
Posttraumatic stress disorder	1.28 (0.19,8.47)	0.801	3.93 (0.53,28.89)	0.179	-	-
Mania (current)	11.95 (0.31,364.54)	0.184	3.03 (0.31,30.13)	0.343	-	-
Mania (past)	-	-	-	-	14.58 (0.68, 312.19.)	0.086
Hypomanic (current)	9.28 (2.56,33.64)	0.001	7.10 (1.41,35.70)	0.017	-	-
MoCA	0.99 (0.94,1.04)	0.721	0.95 (0.86,1.05)	0.316	-	-
MSPSS	1.00 (0.98,1.01)	0.720	1.00 (0.97,1.03)	0.824	0.92 (0.86,0.97)	0.005
NI	1.02 (0.99,1.05)	0.166	1.04 (0.97,1.11)	0.251	1.01 (0.91,1.12)	0.812
TGDS-15	1.29 (1.18,1.40)	<0.001	1.08 (0.92,1.28)	0.350	1.15 (0.90,1.48)	0.263
T-PSS-10	1.02 (0.98,1.07)	0.268	1.08 (0.99,1.17)	0.073	1.06 (0.93,1.21)	0.370
CSI anxiety	0.85 (0.77,0.93)	0.001	0.90 (0.77,1.06)	0.204	0.95 (0.78,1.16)	0.322
N	712		713		715
Model Χ^2 (df)	134.03(19), p<0.001		56.39(15), p<0.001		28.21(15), p<0.05
Model McFadden R^2	0.330		0.553		0.298

Abbreviations: OR, odds ratio; CI, confidence interval; MoCA, The Montreal cognitive assessment; MSPSS, multidimensional scale of perceived social support; NI, The Neuroticism Inventory; TGDS-15, 15-item Thai Geriatric Depression Scale; CSI, The Core Symptom Index; T-PSS, 10-Item Thai Perceived Stress Scale.