老年期の自殺(老年期の心身医学をめぐって)(第34回日本心身医学会総会)

概要

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Elderly Japanese aged 65 years and older accounted for 13% of the total population in 1992,but suicides among the same age group constituted 27% of all suicides. Reports from many other countries world-wide have also indicated high suicide rates among the elderly. Furthermore, Japan's elderly population is expected to grow to 240% by the year 2020. Therefore, elderly suicide, which is already a significant problem in Japan, may become a more serious social issue in the future. In addition to general risk factors for suicide, there are a number of typical features of suicidal elderly. This paper discusses the characteristics of their psychopathology relevant for detection of the risk at an earlier stage and for starting intervention for those at risk. The topics discussed are : various kinds of loss experienced by the elderly, suicidal threats or suicide attempts, physical illness, psychiatric disorders, accident proneness (chronic self-destructive behavior) , inadequate support systems, risk of suicide pact or cluster suicide, and typical personality traits. lssues of somatization developed by suicidal elderly are discussed in detail. Japanese suicidal elderly tend to show various amorphous physical symptoms rather than clear-cut depressive symptoms. They themselves firmly believe that they are suffering from some forms of physical illness, not psychological problems or psychiatric disorders, partly because they have a strong sense of shame about seeking help from mental health professionals ; instead, they consult general practitioners who specialize neither in psychiatry nor psychiatric disorders in the elderly. Therefore, intervention to initiate proper treatment is often so late that preventable suicide unfortunately occurs. Not much attention has been focused on elderly suicide so far. In order to understand the risk of elderly suicide and prevent it, the risk should be examined comprehensively from psychosocio-biological viewpoints. To achieve this goal, accurate knowledge about warning signs in suicidal elderly persons and the characteristics of their psychopathology should be obtained not only by mental health professionals, but also by the elderly themselves, their family members and medical professionals in general. In addition, well organized social support networks should be established for those at risk in the community, without depending too much upon family mem- bers, who used to carry much of the burden in the past.
日本心身医学会の論文
1994-01-01

老年期の自殺(老年期の心身医学をめぐって)(第34回日本心身医学会総会)

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