Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2022; 12(1): 187-203
Published online Jan 19, 2022. doi: 10.5498/wjp.v12.i1.187
Risk factors for suicidal behaviour in late-life depression: A systematic review
Veronica Fernandez-Rodrigues, Yolanda Sanchez-Carro, Luisa Natalia Lagunas, Laura Alejandra Rico-Uribe, Andres Pemau, Patricia Diaz-Carracedo, Marina Diaz-Marsa, Gonzalo Hervas, Alejandro de la Torre-Luque
Veronica Fernandez-Rodrigues, Andres Pemau, Patricia Diaz-Carracedo, Gonzalo Hervas, Department of Psychology, Universidad Complutense de Madrid, Madrid 28223, Spain
Yolanda Sanchez-Carro, Department of Psychiatry, Universidad Autonoma de Madrid, Madrid 28046, Spain
Yolanda Sanchez-Carro, Laura Alejandra Rico-Uribe, Marina Diaz-Marsa, Alejandro de la Torre-Luque, Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
Luisa Natalia Lagunas, Marina Diaz-Marsa, Alejandro de la Torre-Luque, Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
Laura Alejandra Rico-Uribe, Department of Psychology, La Rioja International University, Logrono 26006, Spain
Marina Diaz-Marsa, Institute of Psychiatry and Mental Health, San Carlos Clinical Hospital, Madrid 28040, Spain
Author contributions: Fernandez-Rodrigues V and de la Torre-Luque A conceptualised the research questions, interpreted the study results, wrote the original draft, elaborated the study protocols, and conducted the searches; Fernandez-Rodrigues V, Sanchez-Carro Y, Rico-Uribe LA, and Lagunas LN conducted the study review; de la Torre-Luque A, Hervas G, and Diaz-Marsa M were involved in study supervision; all the authors contributed to this study and were involved in reviewing and editing the final manuscript.
Supported by Instituto de Salud Carlos III-FIS, co-supported by European Regional Development Fund (ERDF) 'a way to build Europe', No. PI20/00229 and No. PI19/01256.
Conflict-of-interest statement: The authors report that they have no conflict of interest to be disclosed.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Luisa Natalia Lagunas, PhD, Academic Fellow, Assistant Professor, Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, 2 Seneca Avenue, Madrid 28046, Spain.
Received: May 4, 2021
Peer-review started: May 4, 2021
First decision: September 5, 2021
Revised: September 17, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: January 19, 2022
Research background

Suicide is one of the most relevant health hazards worldwide, particularly in old age with elevated rates of mortality by suicide. Depression constitutes the most prevalent mental health condition in old age, affecting almost one in five older adults at a community level. Depression is one of the most relevant risk factor for suicide behaviour in its multiple forms (i.e., ideation, attempt, and completed suicide).

Research motivation

This study comes from the interest in reinforcing lines on research at community and clinical levels so as to improve the quality of life of older patients that may show severe mental health conditions: Older adults with depression and suicidal ideation and behaviour.

Research objectives

This study aimed to analyse the relationship between risk factors for suicide behaviour development and late-life depression, as well as to explore the effects of depression treatment on suicide behaviour.

Research methods

A systematic review was conducted covering the period from 2000 onwards, by selecting scientific papers on the relationship between late-life depression and suicide. The review was conducted following the guidelines proposed by the PRISMA-P 2015 statement.

Research results

Factors related to depressive episode severity, psychiatric comorbidity, poorer health status, and disability were highlighted to be related with the emergence of suicide behaviour among depressive older adults. Psychosocial factors were also involved in suicide behaviour emergence. Finally, suicidal behaviour was proven to be a key predictor of depression treatment response.

Research conclusions

Very few studies were focused on severe suicidal behaviour. For that reason, further research is needed to accurately disentangle the pathways involved in the transition between ideation and suicide attempt to prevent death by suicide. Changes in suicidal ideation seem to be decisive in terms of depressive disorder prognosis in late life.

Research perspectives

The results may help increase the awareness on the study of mechanisms involved in suicide from people at risk, as those with a depressive disorder, an actual lure in late life, taking into account its devastating impact in terms of mental health and wellbeing.