Résumés
Résumé
Le suicide de la personne âgée pose la question de notre relation à la vieillesse et à la mort. Significativement lié à la dépression, il est relativement élevé dans cette tranche d’âge. Les conduites suicidaires de la personne âgée présentent des particularités cliniques : une intentionnalité et une létalité suicidaire élevées, peu d’antécédents personnels de conduites suicidaires et un faible niveau d’impulsivité et d’agressivité. La vulnérabilité suicidaire pourrait reposer sur des mécanismes étiopathogéniques à la fois communs et différents selon l’âge. Par exemple, il y aurait une prépondérance des facteurs développementaux précoces marqués par de l’impulsivité et de l’agressivité chez l’adolescent et le jeune adulte ; chez l’adulte âgé, il y aurait un vieillissement pathologique. Des déficits neurocognitifs similaires conduisent le sujet à ne pas pouvoir répondre adéquatement à son environnement, différent selon l’âge. La comparaison directe des sujets jeunes et âgés est nécessaire pour comprendre la genèse de la vulnérabilité suicidaire. Nous conclurons cet article avec un résumé des principes de reconnaissance et de prise en charge du risque suicidaire.
Abstract
Suicide in the elderly raises the question of our relationship with aging and death. Suicide rate is relatively high in this group and is significantly related to depression widely under-diagnosed in the elderly. Suicidal behaviour in the elderly has clinical specificities including high intentionality and lethality, usually little personal history of suicidal behaviour and low levels of impulsivity—aggression. Suicidal vulnerability could rely on etiopathogenic mechanisms both common and different according to age; for example, a preponderance of early developmental factors and impulsivity-aggression in adolescents and young adults vs. pathological aging in older adults, but partly similar neurocognitive deficits leading individuals not to respond adequately to their environment (itself different with age). Direct comparisons between elderly and younger subjects would be required. The article concludes with a summary of the principles of recognition and management of suicide risk.
Parties annexes
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