Increased suicidal risk amongst aging holocaust survivors

Background

Suicide rates are higher in the elderly than in any other phase of the life-cycle. Trauma related syndromes have demonstrated a high degree of associated suicidality. The majority of World War II (WWII) veterans and Holocaust survivors still define their war experiences as being the: "most significant stressors" of their lives. Aging of survivors is frequently associated with reactivation of traumatic syndromes, physical disorders, loss and psychological distress possibly increasing the risk of suicide. The aim of the present study was to investigate amongst a large cohort of elderly Holocaust survivors whether their WWII experiences confer an increased risk of suicidal behavior.

Material and Methods

All medical records of elderly patients admitted to a psychiatric hospital in Israel during a 5-year period were retrospectively evaluated. Suicidal patients were compared to patients who had not attempted suicide.

Results

Of 921 eligible patients, 135 (14.6%) had attempted suicide in the month prior to admission. There were 374 Holocaust survivors in our series. Ninety Holocaust survivors (24%) who had attempted suicide are the index group. Among the 502 patients with no WWII experience 45 had attempted suicide (8.2%). The risk of attempted suicide amongst Holocaust survivors was significantly increased, Odds Ratio = 3.53; 95% CI: 1.8–5.4.

Discussion

Although these findings are from a highly selected sample we suggest that aging Holocaust survivors of WWII are at increased risk of attempting suicide. The growth of the elderly population of whom many had had traumatic life experiences emphasizes the need to implement preventive strategies so that suicidal risk may be contained.