Lisa C Barry1, Emil Coman2, Dorothy Wakefield3, Robert L Trestman4, Yeates Conwell5, David C Steffens6. 1. University of Connecticut School of Medicine, Department of Psychiatry, Farmington, CT 06030-5215, US; University of Connecticut Health Center, UConn Center on Aging, Farmington, CT 06030-5215, US. Electronic address: LiBarry@uchc.edu. 2. University of Connecticut Health Center, Health Disparities Institute, Farmington, CT 06030-7030, US. 3. University of Connecticut Health Center, UConn Center on Aging, Farmington, CT 06030-5215, US. 4. Virginia Tech Carilion School of Medicine, Department of Psychiatry, Roanoke, VA 24016, US. 5. Yeates Conwell, MD, University of Rochester School of Medicine, Rochester, NY 14627, US. 6. University of Connecticut School of Medicine, Department of Psychiatry, Farmington, CT 06030-5215, US.
Abstract
BACKGROUND: The population of older prisoners (age ≥50), a group with high suicide rates, is growing. We sought to explore the associations among functional disability, depression, and suicidal ideation (SI) among older prisoners, focusing on the mediating role of depression. METHODS: Study participants were 220 sentenced male inmates age ≥50 who were incarcerated in 8 prisons. Face-to-face interviews were conducted following consent. Functional disability was assessed objectively, using the Short Physical Performance Battery (SPPB), and via self-report by asking participants their level of difficulty climbing stairs and completing activities necessary for daily living in prison (PADLS) such as standing in line for medications. The PHQ-9 and the Geriatric Suicide Ideation Scale assessed depressive symptoms and SI, respectively. Data were analyzed using linear regression models and causal mediation models. RESULTS: Participants were racially diverse and ranged from age 50 to 79 years. Whereas each functional disability measure was significantly associated with depressive symptoms, difficulty climbing stairs and PADL disability, but not SPPB score, were independently associated with SI. Depressive symptoms mediated the relationship between functional disability, assessed both objectively and via self-report, and SI. LIMITATIONS: Cross-sectional study design; possible under-sampling of participants with depressive symptoms and SI. CONCLUSIONS: Our findings have implications for suicide prevention in older prisoners. As this population continues to grow, prevention efforts should target those with depression, including but not limited to those with functional disability. Furthermore, assessing functional disability may offer a means of identifying those who should be screened for depression and suicidal ideation.
BACKGROUND: The population of older prisoners (age ≥50), a group with high suicide rates, is growing. We sought to explore the associations among functional disability, depression, and suicidal ideation (SI) among older prisoners, focusing on the mediating role of depression. METHODS: Study participants were 220 sentenced male inmates age ≥50 who were incarcerated in 8 prisons. Face-to-face interviews were conducted following consent. Functional disability was assessed objectively, using the Short Physical Performance Battery (SPPB), and via self-report by asking participants their level of difficulty climbing stairs and completing activities necessary for daily living in prison (PADLS) such as standing in line for medications. The PHQ-9 and the Geriatric Suicide Ideation Scale assessed depressive symptoms and SI, respectively. Data were analyzed using linear regression models and causal mediation models. RESULTS:Participants were racially diverse and ranged from age 50 to 79 years. Whereas each functional disability measure was significantly associated with depressive symptoms, difficulty climbing stairs and PADL disability, but not SPPB score, were independently associated with SI. Depressive symptoms mediated the relationship between functional disability, assessed both objectively and via self-report, and SI. LIMITATIONS: Cross-sectional study design; possible under-sampling of participants with depressive symptoms and SI. CONCLUSIONS: Our findings have implications for suicide prevention in older prisoners. As this population continues to grow, prevention efforts should target those with depression, including but not limited to those with functional disability. Furthermore, assessing functional disability may offer a means of identifying those who should be screened for depression and suicidal ideation.
Authors: Stephanie Grace Prost; Cynthia Golembeski; Vyjeyanthi S Periyakoil; Jalayne Arias; Andrea K Knittel; Jessica Ballin; Heather D Oliver; Nguyen-Toan Tran Journal: Int J Prison Health Date: 2022-04-05
Authors: Gang Tian; Rui Li; Yiran Cui; Tong Zhou; Yan Shi; Wenyan Yang; Yulan Ma; Jingliang Shuai; Yan Yan Journal: Front Public Health Date: 2022-08-19