The impact of suicidal death of rural older people to their relatives: Results from a national psychological autopsy study in China

Objective: The suicide pattern in China is changing to a predominance of older people. However, little is known about the impact of suicide on the family members of elderly decedents. The aim of this study was to evaluate whether the suicidal death of rural older adults in China increases the odds of depression or suicidal ideation among their relatives and to explore the associated risk factors.

Methods: In a national psychological autopsy study in China, consecutive samples of suicide decedents aged 60 or above and matched living controls were enrolled in rural areas of three provinces. Univariate and multivariate analyses were performed to explore the occurrence and correlates of depression and suicidal ideation among relatives of elderly suicide decedents.

Results: A total of 242 suicide decedents and 242 living controls were identified. We enrolled 245 relatives of suicide decedents and 205 relatives of living controls. No significant differences in depression or suicide ideation were found between the relatives of suicide decedents and living comparisons after controlling for socio-demographic characteristics (depression: 26.5% vs. 21.5%; suicide ideation: 5.7% vs. 2.9%). A mood disorder diagnosis in the suicide decedent (OR = 1.93, 95% CI 1.12-3.52) and a spouse relationship (OR = 3.62, 95% CI 1.40-9.34) were independent risk factors for depression among relatives of suicide decedents. Spouses (OR = 5.91, 95% CI 1.49-23.38) were more likely to have suicidal ideation than other relatives.

Limitations: there are methodological limitations in psychological autopsy studies.

Conclusions: It seems that the suicide of an older adult 2-6 months ago has no significant impact on depressive symptoms and suicidal ideation in their relatives. Proactive support should be provided for spouses of suicide decedents and those whose relatives have a mood disorder diagnosis.