Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 11
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Redden, William Maurice 2017. Ethnogeriatrics.

    Alarcón, Renato D Parekh, Amrita Wainberg, Milton L Duarte, Cristiane S Araya, Ricardo and Oquendo, María A 2016. Hispanic immigrants in the USA: social and mental health perspectives. The Lancet Psychiatry, Vol. 3, Issue. 9, p. 860.

    Jones, Sherry Everett Pezzi, Clelia Rodriguez-Lainz, Alfonso and Whittle, Lisa 2016. Health Risk Behaviors by Length of Time in the United States Among High School Students in Five Sites. Journal of Immigrant and Minority Health, Vol. 18, Issue. 1, p. 150.

    Kene, Prachi Brabeck, Kalina M. Kelly, Catherine and DiCicco, Brian 2016. Suicidality among immigrants: Application of the interpersonal-psychological theory. Death Studies, Vol. 40, Issue. 6, p. 373.

    Price, James H. and Khubchandani, Jagdish 2016. Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001–2013. Journal of Immigrant and Minority Health,

    Brown, Monique J. Cohen, Steven A. and Mezuk, Briana 2015. Duration of US residence and suicidality among racial/ethnic minority immigrants. Social Psychiatry and Psychiatric Epidemiology, Vol. 50, Issue. 2, p. 257.

    Di Thiene, Domitilla Alexanderson, K Tinghög, P La Torre, G and Mittendorfer-Rutz, E 2015. Suicide among first-generation and second-generation immigrants in Sweden: association with labour market marginalisation and morbidity. Journal of Epidemiology and Community Health, Vol. 69, Issue. 5, p. 467.

    Plener, Paul L Munz, Lara M Allroggen, Marc Kapusta, Nestor D Fegert, Jörg M and Groschwitz, Rebecca C 2015. Immigration as risk factor for non-suicidal self-injury and suicide attempts in adolescents in Germany. Child and Adolescent Psychiatry and Mental Health, Vol. 9, Issue. 1,

    Ai, Amy L. Weiss, Saskia I. and Fincham, Frank D. 2014. Family Factors Contribute to General Anxiety Disorder and Suicidal Ideation Among Latina Americans. Women's Health Issues, Vol. 24, Issue. 3, p. e345.

    Tovilla-Zárate, Carlos Alfonso González-Castro, Thelma Beatriz Juárez-Rojop, Isela Pool García, Sherezada Velázquez-Sánchez, Martha Patricia Villar-Soto, Mario Genis, Alma Nicolini, Humberto López-Narváez, María Lilia and Jiménez-Santos, María Antonia 2014. Study on genes of the serotonergic system and suicidal behavior: protocol for a case–control study in Mexican population. BMC Psychiatry, Vol. 14, Issue. 1,

    Bani-Fatemi, Ali Polsinelli, Gina Kennedy, James L and De Luca, Vincenzo 2013. Ethnicity and suicide attempt: analysis in bipolar disorder and schizophrenia. BMC Psychiatry, Vol. 13, Issue. 1,


Suicidality, ethnicity and immigration in the USA

  • G. Borges (a1), R. Orozco (a1), C. Rafful (a1), E. Miller (a2) and J. Breslau (a3)
  • DOI:
  • Published online: 26 October 2011

Suicide is the 11th leading cause of death in the USA. Suicide rates vary across ethnic groups. Whether suicide behavior differs by ethnic groups in the USA in the same way as observed for suicide death is a matter of current discussion. The aim of this report was to compare the lifetime prevalence of suicide ideation and attempt among four main ethnic groups (Asians, Blacks, Hispanics, and Whites) in the USA.


Suicide ideation and attempts were assessed using the World Mental Health version of the Composite International Diagnostic Interview (WMH-CIDI). Discrete time survival analysis was used to examine risk for lifetime suicidality by ethnicity and immigration among 15 180 participants in the Collaborative Psychiatric Epidemiological Surveys (CPES), a group of cross-sectional surveys.


Suicide ideation was most common among Non-Hispanic Whites (16.10%), least common among Asians (9.02%) and intermediate among Hispanics (11.35%) and Non-Hispanic Blacks (11.82%). Suicide attempts were equally common among Non-Hispanic Whites (4.69%), Hispanics (5.11%) and Non-Hispanic Blacks (4.15%) and less common among Asians (2.55%). These differences in the crude prevalence rates of suicide ideation decreased but persisted after control for psychiatric disorders, but disappeared for suicide attempt. Within ethnic groups, risk for suicidality was low among immigrants prior to migration compared to the US born, but equalized over time after migration.


Ethnic differences in suicidal behaviors are explained partly by differences in psychiatric disorders and low risk prior to arrival in the USA. These differences are likely to decrease as the US-born proportion of Hispanics and Asians increases.

Corresponding author
*Address for correspondence: Dr G. Borges, Departamento de Modelos de Intervención, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría, Calzada México Xochimilco No. 101, Col. San Lorenzo Huipulco, México D.F., C.P. 14370, Mexico. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

M Alegria , N Mulvaney-Day , M Torres , A Polo , Z Cao , G Canino (2007). Prevalence of psychiatric disorders across Latino subgroups in the United States. American Journal of Public Health 97, 6875.

E Baca-Garcia , MM Perez-Rodriguez , K Keyes , MA Oquendo , D Hasin , BF Grant , C Blanco (2010). Suicidal ideation and suicide attempts in the United States: 1991–1992 and 2001–2002. Molecular Psychiatry 15, 250259.

E Baca-Garcia , MM Perez-Rodriguez , K Keyes , MA Oquendo , D Hasin , BF Grant , C Blanco (2011). Suicidal ideation and suicide attempts among Hispanic subgroups in the United States: 1991–1992 and 2001–2002. Journal of Psychiatric Research 45, 512518.

G Borges , J Angst , MK Nock , AM Ruscio , RC Kessler (2008). Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. Journal of Affective Disorders 105, 2533.

G Borges , J Breslau , M Su , M Miller , ME Medina-Mora , S Aguilar-Gaxiola (2009). Immigration and suicidal behavior among Mexicans and Mexican-Americans. American Journal of Public Health 99, 728733.

G Borges , MK Nock , JM Haro , I Hwang , N Sampson , J Alonso , L Andrade , M Angermeyer , AL Beautrais , E Bromet , R Bruffaerts , G Girolamo , S Florescu , O Gureje , C Hu , EG Karam , V Kovess , S Lee , D Levinson , ME Medina-Mora , J Ormel , J Posada-Villa , R Sagar , T Tomov , H Uda , DR Williams , RC Kessler (2010). Twelve month prevalence of and risk factors for suicide attempts in the WHO World Mental Health Surveys. Journal of Clinical Psychiatry 71, 16171628.

J Breslau , S Aguilar-Gaxiola , G Borges , K Kendler , M Su , RC Kessler (2007). Risk for psychiatric disorder among immigrants and their US-born descendants: evidence from the National Comorbidity Survey Replication. Journal of Nervous and Mental Disease 195, 189195.

J Breslau , DF Chang (2006). Psychiatric disorders among foreign-born and US-born Asian-Americans in a US national survey. Social Psychiatry and Psychiatric Epidemiology 41, 943950.

G Canino , RE Roberts (2001). Suicidal behavior among Latino youth. Suicide and Life-Threatening Behavior 31, 122131.

JL Choi , JR Rogers , Jr. JL Werth (2007). Suicide risk assessment with Asian American college students: a culturally informed perspective. The Counselling Psychologist 37, 186218.

AA Duldulao , D Takeuchi , S Hong (2009). Correlates of suicidal behaviors among Asian Americans. Archives of Suicide Research 13, 277290.

B Efron (1988). Logistic regression, survival analysis, and the Kaplan-Meier curve. Journal of the American Statistical Association 83, 414425.

LR Fortuna , DJ Perez , C Canino , W Sribney , M Alegria (2007). Prevalence and correlates of lifetime suicidal ideation and suicide attempts among Latino subgroups in the United States. Journal of Clinical Psychiatry 68, 572581.

H Galfalvy , YY Huang , MA Oquendo , D Currier , JJ Mann (2009). Increased risk of suicide attempt in mood disorders and TPH1 genotype. Journal of Affective Disorders 115, 331338.

RB Goldstein , DW Black , A Nasrallah , G Winokur (1991). The prediction of suicide. Sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patients with affective disorders. Archives of General Psychiatry 48, 418422.

S Heeringa , J Wagner , M Torres , N Duan , T Adams , P Berglund (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research 13, 221240.

S Joe , R Baser , G Breeden , H Neighbors , JS Jackson (2006). Prevalence of and risk factors for lifetime suicide attempts among blacks in the United States. Journal of the American Medical Association 296, 21122123.

RC Kessler , P Berglund , G Borges , M Nock , PS Wang (2005). Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. Journal of the American Medical Association 293, 24872495.

RC Kessler , G Borges , EE Walters (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry 56, 617626.

B Knauper , CF Cannell , N Schwarz , ML Bruce , RC Kessler (1999). Improving accuracy of major depression age-of-onset reports in the US National Comorbidity Survey. International Journal of Methods in Psychiatric Research 8, 3948.

MK Nock , G Borges , E Bromet , CB Cha , RC Kessler , S Lee (2008). Suicide and suicidal behavior. Epidemiologic Reviews 30, 133154.

MK Nock , I Hwang , N Sampson , RC Kessler , M Angermeyer , AL Beautrais , G Borges , E Bromet , R Bruffaerts , G de Girolamo , R de Graaf , S Florescu , O Gureje , JM Haro , C Hu , Y Huang , EG Karam , N Kawakami , V Kovess , D Levinson , J Posada-Villa , R Sagar , T Tomov , MC Viana , DR Williams (2009). Cross-national analysis of the associations among mental disorders and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS Medicine 6, e1000123.

MK Nock , MJ Prinstein (2005). Clinical features and behavioral functions of adolescent self-mutilation. Journal of Abnormal Psychology 114, 140146.

MA Oquendo , D Dragatsi , J Harkavy-Friedman , K Dervic , D Currier , AK Burke (2005). Protective factors against suicidal behavior in Latinos. Journal of Nervous and Mental Disease 193, 438443.

MA Oquendo , D Lizardi , S Greenwald , MM Weissman , JJ Mann (2004). Rates of lifetime suicide attempt and rates of lifetime major depression in different ethnic groups in the United States. Acta Psychiatrica Scandinavica 110, 446451.

RE Roberts , CR Roberts , Y Xing (2007). Are Mexican American adolescents at greater risk of suicidal behaviors? Suicide and Life-Threatening Behavior 37, 1021.

GK Singh , RA Hiatt (2006). Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979–2003. International Journal of Epidemiology 35, 903919.

PR Smokowski , C David-Ferdon , N Stroupe (2009). Acculturation and violence in minority adolescents: a review of the empirical literature. Journal of Primary Prevention 30, 215263.

K Suominen , E Isometsa , J Suokas , J Haukka , K Achte , J Lonnqvist (2004). Completed suicide after a suicide attempt: a 37-year follow-up study. American Journal of Psychiatry 161, 562563.

DT Takeuchi , N Zane , S Hong , DH Chae , F Gong , GC Gee , E Walton , S Sue , M Alegria (2007). Immigration-related factors and mental disorders among Asian Americans. American Journal of Public Health 97, 8490.

CF Turner , L Ku , SM Rogers , LD Lindberg , JH Pleck , FL Sonenstein (1998). Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science 280, 867873.

JB Willett , JD Singer (1993). Investigating onset, cessation, relapse, and recovery: why you should, and how you can, use discrete-time survival analysis to examine event occurrence. Journal of Consulting and Clinical Psychology 61, 952964.

DR Williams , R Haile , HM Gonzalez , H Neighbors , R Baser , JS Jackson (2007). The mental health of black Caribbean immigrants: results from the National Survey of American Life. American Journal of Public Health 97, 5259.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *