Substance abuse disorders major depressive disorder-related

Older persons account for one-third of all suicides in the United States even though this group represents only 12% of the population ( 36). Suicide is even more often related to major depression in the elderly than in younger individuals in whom other causes such as substance abuse, bipolar disorder, schizophrenia, and personality disorders often play a major role. In fact, suicide rates are highest in older white men relative to any other segment of the population. For example, white men older than 85 years age commit suicide 30 times as frequently as black women. 

Depression relates to the loss of autonomy, control and physical function, as well as altered family roles and relationships. Many patients meet DSM-IV criteria for the diagnosis of a major depressive episode or disorder. Feelings of helplessness, frustration, guUt, fear, and despair have also been reported among the LTMV population (4-6). Substance abuse also may increase among those with LTMV, requiring that the staff be sensitive to this issue (7). 

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