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Suicide at 50 years of age and older: perceived physical illness, family discord and financial strain

Background. Mental disorders amplify suicide risk across the lifecourse, but most people with mental disorder do not take their own lives. Few controlled studies have examined the contribution of stressors to suicide risk. Method. A case–control design was used to compare 86 suicides and 86 controls aged 50 years and older, matched on age, gender, race and county of residence. Structured interviews were conducted with proxy respondents for suicides and controls. Results. Perceived physical illness, family discord and employment change amplified suicide risk after controlling for sociodemographic covariates and mental disorders that developed [ges ]1 year prior to death/interview. Only the effect of physical illness (OR 6·24, 95% CI 1·28–51·284) persisted after controlling for all active mental disorders. Conclusions. Interventions to decrease the likelihood of financial stress and to help families manage discord and severe physical illness may effectively reduce suicides among middle-aged and older adults.