In a retrospective study of 69 elderly (65 years and over) cases of attempted suicide (deliberate self-harm) referred for psychiatric assessment in southern Sydney, 81% took overdoses, 64% involving benzodiazepines. Depressive illness was present in 87% of cases, alcohol/substance abuse in 32%, organic brain syndromes in 29% and personality dysfunction in 26%. Multiple psychosocial, psychological, medical and psychiatric risk factors for suicide were identified. 'Major' functional psychiatric disorders (41%) were found predominantly in females and were associated with higher levels of suicidal intent, psychosis and fewer chronic physical illnesses. 'Minor' functional disorders (30%) were associated with lower degrees of suicidal intent, personality dysfunction and higher numbers of psychosocial stressors. Organic brain syndromes were associated with males over 75 years, chronic physical illness, and were often comorbid with depression. These findings indicate that there are several patterns of suicidal behaviour in the elderly that require further prospective research.
