Clinical Correlates and Predictors of Suicide Attempt Severity in Elderly Patients: A Cross-Sectional Study from South India

Background: Suicide in late life is a major yet under-recognized public health problem in low- and middle-income countries. Elderly suicidal behaviour reflects interactions between psychiatric morbidity, substance use, psychological distress, intent, and method selection. Indian data examining these factors comprehensively remain limited. Objectives: To assess psychiatric morbidity, hopelessness, suicide intent, planning patterns, methods, and independent predictors of suicide attempt severity among elderly suicide attempters. Methods: This cross-sectional study included 75 elderly individuals (≥60 years) admitted following a suicide attempt to a tertiary care hospital in South India. Depression severity, hopelessness, and suicide intent were assessed using Beck’s Depression Inventory-21 (BDI-21), Beck’s Hopelessness Scale (BHS), and Beck’s Suicide Intent Scale (BSIS). Psychiatric diagnoses were made using DSM-5 criteria. Statistical analyses included appropriate parametric and non-parametric tests and multivariable logistic regression. Results: Depression was highly prevalent (85.3%), with predominantly moderate-to-severe severity and no significant association with demographic variables. Alcohol dependence was present in one-third of the sample and was associated with higher hopelessness and planned suicide attempts. Hopelessness correlated strongly with depression severity (r=0.71, pp=0.005) and alcohol dependence (adjusted OR=5.23, p=0.012) independently predicted suicide attempt severity. Conclusion: Elderly suicide attempts are characterized by high depressive burden, significant hopelessness, deliberate planning, and the contributory role of alcohol dependence. Hopelessness is the strongest independent predictor of suicide severity, highlighting the need for comprehensive psychosocial assessment in late-life suicide prevention.