Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case-control study.

OBJECTIVE To determine the rates of psychiatric disorder and personality variables in a sample of older people who had committed suicide and to compare the rates in a subgroup of this sample with those in a control group of people who died from natural causes. DESIGN Descriptive psychological autopsy study, including interviews with informants, of psychiatric and personality factors in 100 suicides in older people. Case-control study using subgroup of 54 cases and matched control group. SETTING Four counties and one large urban area in central England, UK. SUBJECTS Individuals 60 years old and over at the time of death who had died between 1 January 1995 and 1 May 1998, and whose deaths had received a coroner's verdict of suicide (or an open or accidental verdict, where the circumstances of death indicated probable suicide). The control group was an age-and sex-matched sample of people dying through natural causes in the same time period. MAIN OUTCOME MEASURES ICD-10 psychiatric disorder, personality disorder and trait accentuation. MAIN RESULTS Seventy-seven per cent of the suicide sample had a psychiatric disorder at the time of death, most often depression (63%). Personality disorder or personality trait accentuation was present in 44%, with anankastic or anxious traits the most frequent. Depression, personality disorder, and personality trait accentuation emerged as predictors of suicide in the case-control analysis. CONCLUSION Personality factors, as well as depression, are important risk factors for suicide in older people.