Am J Psychiatry 1991; 148:524-527
Copyright © 1991 by American Psychiatric Association
Suicide, stressors, and the life cycle [published erratum appears in Am J Psychiatry 1991 Jul;148(7):960]
CL Rich, GM Warstadt, RA Nemiroff, RC Fowler, D Young and GM] Warsradt GM$[corrected to Warstadt
San Diego VA Medical Center.
OBJECTIVE: Relationships between stressors and suicide might be expected to
vary with stages of the life cycle. The purpose of this study was to
examine this possibility. METHOD: The authors examined the first 204
consecutive cases from the San Diego Suicide Study, a federally funded
investigation of 283 suicides, for possible relationships between suicide
and age and the frequency of specific stressors. Information was gathered
from family members, spouses, acquaintances, employers, other witnesses,
physicians, and other professionals by trained interviewers using a
structured format. Hospital, physician, therapist, school, and police
records were also included when available. DSM-III diagnoses were made by
consensus of two investigators. Life events information was also reviewed
independently by the investigators to determine stressors (if any) for each
case. RESULTS: Of the 202 subjects for whom data were available, 195 (97%)
had one or more stressors; 137 male subjects had a total of 272 stressors,
and 58 female subjects had a total of 115 stressors. The authors found
predictable patterns of the three most common stressor
groups--conflict-separation-rejection, economic problems, and medical
illness. The majority of the stressors among subjects 80 years old or older
were illnesses. The only significant difference between the sexes was that
more men than women had economic problems as a stressor. CONCLUSIONS: The
variations in the patterns of stressors found in this study of suicides
coincide with adult development theory. The lack of population comparison
subjects and stressor scoring validation, however, limits the predictive
value of these data in assessing suicidal persons.
