Age and gender distribution of suicide ideation and depressive symptoms in a Sardinian community sample (Italy)

Background. Suicide continues to be a significant public health problem, with Italy in 2016 reporting a rate of ap-proximately 7 per 100,000 people, with a predominance (78.8%) of suicides committed by men (the average suicide rate in Russia is 7.8 per 100,000). Although the high incidence of suicidal activity in this population is more typical among older people, suicide remains a leading cause of death among young people as well. Although suicidal ideation is a rec-ognized risk factor, its relationship with completed suicides is not entirely clear. Women are more likely to report suicid-al ideation, while men are more likely to complete suicide, a phenomenon known as the “sex paradox of suicide”. Ob-jective: To study the distribution of suicidal ideation and intent according to age and sex in a representative sample of respondents living in one of the regions of Italy; To analyze gender and age differences in the context of suicidal behav-ior and determine their relationship with depressive symptoms. Methods. A survey of citizens (n=1502) living in Sardin-ia (Italy), including 774 women and 728 men, aged 15 to 80 years, was conducted using a computer-assisted telephone interview (CTI). The presence of depressive symptoms and ideation of death and suicide was assessed using the 9-item Patient Health Questionnaire-9 (PHQ-9). Statistical analyses, including ANOVA and χ2 tests, were used to compare groups. Results. An assessment of death and suicide ideation in women aged ≥75 years revealed higher mean scores for suicidal ideation compared to younger women. No significant age differences in suicidal ideation were observed in men. Men aged ≥60 years had a statistically significantly higher mean score for death and suicide ideation compared to men aged ≤60 years. Discussion. The obtained results reflect a discrepancy between the current understanding of the psychi-atric community and the traditional understanding of the “suicide paradox“. Excessive suicidal ideation in men without depressive symptoms suggests that subthreshold mood disorders, such as recurrent brief depression, dysthymia, and cy-clothymia, associated with circadian rhythm disruption, may significantly contribute to the risk of suicide. This confirms the need for broader screening strategies than traditional diagnosis of depressive disorders. Conclusions. Identifying specific risk factors, such as biological characteristics (age and gender), in patients with subthreshold manifestations of mood disorders may improve the results of suicide prevention efforts. An in-depth study of the role of recurrent brief depression, dysthymia, and cyclothymia associated with circadian rhythm disturbances is needed to determine the level of suicidal intent.