Medeišytė, Radvilė; (2024) Exploring social isolation and loneliness in adults over 50 with high autistic traits. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Links have been identified between dementia and risk of suicidal ideation, suicide attempts and death by suicide, but to date there has been no systematic review of how mental health comorbidity is related to suicide outcomes in people living with dementia (PwD). I systematically searched five bibliographic databases for articles published from database inception to July 2023. I identified six mental health factors for meta-analysis: depression, anxiety, substance use, schizophrenia, personality disorder, and general psychiatric comorbidity. 13 studies met inclusion criteria for the current study. For some mental health factors, sufficient studies were available to examine only one type of suicide outcome, while for other factors, research covered two or all three suicide outcomes. Depression, anxiety, substance use and general psychiatric comorbidity were associated with higher rates of death by suicide; the association was not significant for schizophrenia. Depression, anxiety and personality disorder were associated with higher rates of attempted suicide. Depression was not associated with a difference in suicidal ideation, although the narrative review suggested an association with higher rates of suicidal ideation. Heterogeneity in the meta-analyses was generally high which limits the conclusions that can be drawn at this stage. However, there appears to be emerging evidence for a range of mental health comorbidities being linked to increased risk of suicide outcomes in PwD. Future directions for research are suggested, and clinical implications include the importance of addressing the risk of suicide in PwD with mental health difficulties even in the absence of disclosed suicidal ideation.

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