Mapping psychosocial risk and protective factors in suicidal older persons- a systematic review

Abstract

Social disconnectedness in combination with depression, somatic disease, stigma, social exclusion and functional impairment has been described as a major risk factor for suicide in old age. However, protective factors have not been focused on in the same way. The aim was to identify psychosocial risk and protective factors in suicidal older persons. A systematic review was performed in Academic Search Premier (34), Ovid Medline (0), PsycInfo (0), PubMed (66), CINAHL (3) and ProQuest (1078) for the period May - September, 2014. Results: Twelve studies were included in the final analysis. Psychosocial risk factors were categorized under four themes: Being a burden to others increases depression and hopelessness, The struggle due to poor social integration, The strain of physical illness and old age and Negative aspects of religious activity. A total of four protective factors emerged: A sense of belonging, Maintaining social dignity, Satisfaction with relationships and feeling useful and Positive aspects of religious activity. In conclusion, the context of a suicidal older person in a home healthcare service may create a ‘vulnerable psychosocial state’ in which she/he is confronted by stressful psychosocial life events including physical illness and social network changes. The fact that protective factors were solely related to social factors needs to be taken into account in future prevention studies.