ArticleThe Journal of clinical psychiatry
Pathways to Late-Life Suicidal Behavior: Cluster Analysis and Predictive Validation of Suicidal Behavior in a Sample of Older Adults With Major Depression.
Article in The Journal of clinical psychiatry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06529029 (Efficacy of Low Amplitude Pulse Seizure Therapy Versus Standard Ultra-Brief Right Unilateral Electroconvulsive Therapy in Remission of Suicidal Ideation), which is not on this map. Cited by 37 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy of Low Amplitude Pulse Seizure Therapy Versus Standard Ultra-Brief Right Unilateral Electroconvulsive Therapy in Remission of Suicidal Ideation
Who cites it
37 citing papers in PubMed.
- Age matters: a narrative review and machine learning analysis on shared and separate multidimensional risk domains for early and late onset suicidal behavior.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Review
- Predictive models for active suicidal ideation in cognitive decline: identifying risk factors.BMC psychiatry · 2026Article
- Brain Volume Reductions and Relationship With Depression and Cognitive Functioning in Suicide in Older Adults: A Cross-Sectional and Longitudinal Study Using Bayesian Multilevel Modeling.Biological psychiatry global open science · 2025Article
- Long-term risk of late-life depression in widowed elderly: a five-year follow-up study.BMC geriatrics · 2025Article
- Objective and subjective suicidal intent are differentially associated with attempt lethality based on age of onset of suicidal behavior.Scientific reports · 2025Article
- Measures of healthcare decision-making ability in cognitive aging: a scoping review from the Advancing Reliable Measurement in Cognitive Aging and Decision-Making Ability (ARMCADA) research initiative.Frontiers in public health · 2025Article
- Diligent for better or worse: Conscientiousness is associated with higher likelihood of suicidal behavior and more severe suicidal intent in later life.Comprehensive psychiatry · 2024Article
- Risk for Suicide and Homicide Peaks at Night: Findings From the National Violent Death Reporting System, 35 States, 2003-2017.The Journal of clinical psychiatry · 2024Article
- Childhood trauma is associated with early-onset but not late-onset suicidal behavior in late-life depression.International psychogeriatrics · 2024Article
- Is Late-Onset Suicidal Behavior a Distinct Subtype?The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2024Review
- Real-world evidence from a retrospective study on suicide during depression: clinical characteristics, treatment patterns and disease burden.BMC psychiatry · 2024Article
- Life-Satisfaction, Engagement, Mindfulness, Flourishing, and Social Support: Do they Predict Depression, Suicide Ideation, and History of Suicide Attempt in Late Life?The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2023Article
- Suicidal urges and attempted suicide at multiple time scales in borderline personality disorder.Journal of affective disorders · 2023Article
- Long-Term Suicidal Ideation Profiles in Late-Life Depression and Their Association With Suicide Attempt or Death by Suicide.The Journal of clinical psychiatry · 2023Article
- Passive and active suicidal ideation in a population-based sample of older adults: Associations with polygenic risk scores of relevance for suicidal behavior.Frontiers in psychiatry · 2023Article
- Mental health care for older adults: recent advances and new directions in clinical practice and research.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2022Article
- The Role of Perceived and Objective Social Connectedness on Risk for Suicidal Thoughts and Behavior in Late-Life and Their Moderating Effect on Cognitive Deficits.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2022Article
- Integrating a functional view on suicide risk into idiographic statistical models.Behaviour research and therapy · 2022Article
- Search for solutions, learning, simulation, and choice processes in suicidal behavior.Wiley interdisciplinary reviews. Cognitive science · 2022Review
- Personality Disorders in Older Age.Focus (American Psychiatric Publishing) · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveClinical heterogeneity is a key challenge to understanding suicidal risk, as different pathways to suicidal behavior are likely to exist. We aimed to identify such pathways by uncovering latent classes of late-life depression cases and relating them to prior and future suicidal behavior.
methodsData were collected from June 2010 to September 2015. In this longitudinal study we examined distinct associations of clinical and cognitive/decision-making factors with suicidal behavior in 194 older (50+ years) nondemented, depressed patients; 57 nonpsychiatric healthy controls provided benchmark data. The DSM-IV was used to establish diagnostic criteria. We identified multivariate patterns of risk factors, defining clusters based on personality traits, perceived social support, cognitive performance, and decision-making in an analysis blinded to participants' history of suicidal behavior. We validated these clusters using past and prospective suicidal ideation and behavior.
resultsOf 5 clusters identified, 3 were associated with high risk for suicidal behavior: (1) cognitive deficits, dysfunctional personality, low social support, high willingness to delay future rewards, and overrepresentation of high-lethality attempters; (2) high-personality pathology (ie, low self-esteem), minimal or no cognitive deficits, and overrepresentation of low-lethality attempters and ideators; (3) cognitive deficits, inability to delay future rewards, and similar distribution of high- and low-lethality attempters. There were significant between-cluster differences in number (P < .001) and lethality (P = .002) of past suicide attempts and in the likelihood of future suicide attempts (P = .010, 30 attempts by 22 patients, 2 fatal) and emergency psychiatric hospitalizations to prevent suicide (P = .005, 31 participants).
conclusionsThree pathways to suicidal behavior in older patients were found, marked by (1) very high levels of cognitive and dispositional risk factors suggesting a dementia prodrome, (2) dysfunctional personality traits, and (3) impulsive decision-making and cognitive deficits.
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