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Depression subtype, age, and prior attempts shaped suicide risk and costs in older adults receiving psychiatric care.  

The study published in June 2025 in the issue of Frontiers in Psychiatry highlighted the rising burden of depression in older adults (OAs) and the limited understanding of how depressive disorders placed among the 3 leading causes of disability, low back pain, and headache disorders, and their association costs influenced suicide risk.    

Researchers conducted a retrospective study to examine the sociodemographic and clinical characteristics linked to depression subtypes, suicidality, and related healthcare costs among OAs receiving mental healthcare.  

They implemented the study across 4 psychiatry departments in Madrid, Spain, involving individuals aged over 60 years who accessed inpatient or outpatient psychiatric services and were diagnosed with Major Depressive Disorder (MDD), recurrent depressive disorder, bipolar depression, or dysthymia. Sociodemographic data and diagnoses were retrieved from electronic health records using the International Classification of Diseases, 10th edition. The Columbia Suicide Severity Rating Scale (CSSRS) was used to assess lifetime suicidal history, recent suicidal ideation, and suicide attempts within the past month. Mean healthcare costs were estimated over a 12-month period.  

The results showed that 2,868 individuals were included, with 550 assessed using the CSSRS. The average age was 70.05 years, and 75.9% (N=2,177) were women. Among those evaluated with the CSSRS (N=550), 83.2% (N=458) reported suicidal ideation, and 7.3% (N=40) had attempted suicide in the past month. Psychiatric care costs varied across depressive subtypes [Eta-squared 0.003, 95% CI (0.000–0.008); P<0.001], with higher expenses for bipolar depression compared to dysthymia (P=0.026), but no significant difference with MDD (P=0.775) or recurrent depressive disorder (P=0.129). Individuals with recent suicide attempts had greater odds of a lifetime suicide attempt history [OR=8.434]. Suicide attempts were more likely in those aged 71–80 years (OR=3.433), over 80 years (OR=3.322), and among individuals with recurrent depressive disorder (OR=3.529).  

Investigators concluded that psychiatric care costs varied modestly by depression subtype, and suicide risk was higher in OAs with recurrent depression and prior to suicide attempts.  

Source: frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1560719/full