Hostname: page-component-76d6cb85b7-mgxrv Total loading time: 0 Render date: 2026-07-15T02:17:46.944Z Has data issue: false hasContentIssue false
  • English
  • Français

Cross-national prevalence and risk factors for suicidal ideation, plans and attempts

Published online by Cambridge University Press:  02 January 2018

Matthew K. Nock ,
Guilherme Borges ,
Evelyn J. Bromet ,
Jordi Alonso ,
Matthias Angermeyer ,
Annette Beautrais ,
Ronny Bruffaerts ,
Wai Tat Chiu ,
Giovanni de Girolamo  and
Semyon Gluzman
...Show all authors
Matthew K. Nock*
Affiliation:
Department of Psychology, Harvard University, Massachusetts, USA
Guilherme Borges
Affiliation:
Department of Epidemiology, National Institute of Psychiatry and Universidad Autonoma Metropolitana, Mexico City, Mexico
Evelyn J. Bromet
Affiliation:
Department of Psychiatry, State University of New York, Stony Brook, USA
Jordi Alonso
Affiliation:
Health Services Research Unit, Institut Municipal d'Investigacio Medica IMIM, Barcelona, Spain
Matthias Angermeyer
Affiliation:
University of Leipzig, Department of Psychiatry, Leipzig, Germany
Annette Beautrais
Affiliation:
Christchurch School of Medicine & Health Sciences, New Zealand
Ronny Bruffaerts
Affiliation:
Department of Neurosciences and Psychiatry, University Hospitals, Gasthuisberg, Belgium
Wai Tat Chiu
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
Giovanni de Girolamo
Affiliation:
Department of Mental Health, AUSL di Bologna, Bologna, Italy
Semyon Gluzman
Affiliation:
Ukrainian Psychiatric Association, Kyiv, Ukraine
Ron de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
Oye Gureje
Affiliation:
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
Josep Maria Haro
Affiliation:
Sant Joan de Deu-SSM, Barcelona, Spain
Yueqin Huang
Affiliation:
Institute of Mental Health, Peking University, People's Republic of China
Elie Karam
Affiliation:
Department of Psychiatry and Psychology, St George Hospital University Medical Center, Beirut, Lebanon
Ronald C. Kessler
Affiliation:
Department of Psychology, Harvard University, Massachusetts, USA
Jean Pierre Lepine
Affiliation:
Hospital Fernand Widal, Paris, France
Daphna Levinson
Affiliation:
Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
Maria Elena Medina-Mora
Affiliation:
Department of Epidemiology, National Institute of Psychiatry and Universidad Autonoma Metropolitana, Mexico City, Mexico
Yutaka Ono
Affiliation:
Keio University, Tokyo, Japan
José Posada-Villa
Affiliation:
Colegio Mayor de Cundinamarca University, Saldarriaga Concha Foundation, Bogota, Colombia
David Williams
Affiliation:
Harvard University School of Public Health, Boston, Massachusetts, USA
*
Matthew K. Nock, PhD, Department of Psychology, Harvard University, 33 Kirkland Street, 1280 Cambridge, MA 02138, USA. Email: nock@wjh.harvard.edu
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.
Background

Suicide is a leading cause of death worldwide; however, the prevalence and risk factors for the immediate precursors to suicide – suicidal ideation, plans and attempts – are not well-known, especially in low- and middle-income countries.

Aims

To report on the prevalence and risk factors for suicidal behaviours across 17 countries.

Method

A total of 84 850 adults were interviewed regarding suicidal behaviours and socio-demographic and psychiatric risk factors.

Results

The cross-national lifetime prevalence of suicidal ideation, plans, and attempts is 9.2% (s.e.=0.1), 3.1% (s.e.=0.1), and 2.7% (s.e.=0.1). Across all countries, 60% of transitions from ideation to plan and attempt occur within the first year after ideation onset. Consistent cross-national risk factors included being female, younger, less educated, unmarried and having a mental disorder. Interestingly, the strongest diagnostic risk factors were mood disorders in high-income countries but impulse control disorders in low- and middle-income countries.

Conclusion

There is cross-national variability in the prevalence of suicidal behaviours, but strong consistency in the characteristics and risk factors for these behaviours. These findings have significant implications for the prediction and prevention of suicidal behaviours.

Information

Type
Papers
Information
The British Journal of Psychiatry , Volume 192 , Issue 2 , February 2008 , pp. 98 - 105
Copyright
Copyright © Royal College of Psychiatrists, 2008 

References

1 World Health Organization. Prevention of Suicide: Guidelines for the Formulation and Implementation of National Strategies. World Health Organization, 1996.Google Scholar
2 Vijayakumar, L, Nagaraj, K, Pirkis, J, Whiteford, H. Suicide in developing countries 1: frequency, distribution, and association with socioeconomic indicators. Crisis 2005; 26: 104–11.CrossRefGoogle ScholarPubMed
3 Moscicki, EK. Epidemiology of suicide. In The Harvard Medical School Guide to Suicide Assessment and Intervention (ed Jacobs, D.G.): 40–51. Jossey-Bass, 1999.Google Scholar
4 Kessler, RC, Berglund, P, Borges, G, Nock, MK, Wang, PS. Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. J Am Med Assoc 2005; 293: 2487–95.CrossRefGoogle ScholarPubMed
5 Weissman, MM, Bland, RC, Canino, GJ, Greenwald, S, Hwu, HG, Joyce, PR, Karam, EG, Lee, CK, Lellouch, J, Lepine, JP, Newman, SC, Rubio-Stipec, M, Wells, JE, Wickramaratne, PJ, Wittchen, HU, Yeh, EK. Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 1999; 29: 9–17.CrossRefGoogle ScholarPubMed
6 Kessler, RC, Borges, G, Walters, EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry 1999; 56: 617–26.CrossRefGoogle ScholarPubMed
7 Vijayakumar, L. Suicide prevention: the urgent need in developing countries. World Psychiatry 2004; 3: 158–9.Google ScholarPubMed
8 Phillips, MR, Yang, G, Zhang, Y, Wang, L, Ji, H, Zhou, M. Risk factors for suicide in China: a national case-control psychological autopsy study. Lancet 2002; 360: 1728–36.CrossRefGoogle Scholar
9 Mann, JJ, Apter, A, Bertolote, J, Beautrais, A, Currier, D, Haas, A, Hegerl, U, Lonnqvist, J, Malone, K, Marusic, A, Mehlum, L, Patton, G, Phillips, M, Rutz, W, Rihmer, Z, Schmidtke, A, Shaffer, D, Silverman, M, Takahashi, Y, Varnik, A, Wasserman, D, Yip, P, Hendin, H. Suicide prevention strategies: a systematic review. J Am Med Assoc 2005; 294: 2064–74.Google Scholar
10 Demyttenaere, K, Bruffaerts, R, Posada-Villa, J, Gasquet, I, Kovess, V, Lepine, JP, Angermeyer, MC, Bernert, S, de Girolamo, G, Morosini, P, Polidori, G, Kikkawa, T, Kawakami, N, Ono, Y, Takeshima, T, Uda, H, Karam, EG, Fayyad, JA, Karam, AN, Mneimneh, ZN, Medina-Mora, ME, Borges, G, Lara, C, de Graaf, R, Ormel, J, Gureje, O, Shen, Y, Huang, Y, Zhang, M, Alonso, J, Haro, JM, Vilagut, G, Bromet, EJ, Gluzman, S, Webb, C, Kessler, RC, Merikangas, KR, Anthony, JC, Von Korff, MR, Wang, PS, Brugha, TS, Aguilar-Gaxiola, S, Lee, S, Heeringa, S, Pennell, BE, Zaslavsky, AM, Ustun, TB, Chatterji, S; on behalf of the WHO World Mental Health Survey Consortium. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004; 291: 2581–90.Google Scholar
11 Platt, S, Bille-Brahe, U, Kerkh of, A, Schmidtke, A, Bjerke, T, Crepet, P, De Leo, D, Haring, C, Lonnqvist, J, Michel, K, Philippe, A, Pommereau, X, Querejeta, I, Salander-Renberg, E, Temesvary, B, Wasserman, D, Sampaio Faria, J. Parasuicide in Europe: the WHO/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989. Acta Psychiatr Scand 1992; 85: 97–104.CrossRefGoogle ScholarPubMed
12 Bertolote, JM, Fleischmann, A, De Leo, D, Bolhari, J, Botega, N, De Silva, D, Tran Thi Thanh, H, Phillips, M, Schlebusch, L, varnik, A, Vijayakumar, L, Wasserman, D. Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey. Psychol Med 2005; 35: 1457–65.CrossRefGoogle ScholarPubMed
13 Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, de Girolamo, G, Graaf, R, Demyttenaere, K, Gasquet, I, Haro, JM, Katz, SJ, Kessler, RC, Kovess, V, Lépine, JP, Ormel, J, Polidori, G, Russo, LJ, Vilagut, G, Almansa, J, Arbabzadeh-Bouchez, S, Autonell, J, Bernal, M, Buist-Bouwman, MA, Codony, M, Domingo-Salvany, A, Ferrer, M, Joo, SS, Martínez-Alonso, M, Matschinger, H, Mazzi, F, Morgan, Z, Morosini, P, Palacín, C, Romera, B, Taub, N, Vollebergh, WA; on behalf of the ESEMeD/MHEDEA 2000 Investigators, European Study of the Epidemiology of Mental Disorders ESEMeD Project. Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 2004; 420: 8–20.Google Scholar
14 World Bank. World Development Indicators 2003. The World Bank, 2003.Google Scholar
15 Kessler, RC, Merikangas, KR. The National Comorbidity Survey Replication (NCS–R): background and aims. Int J Methods Psychiatr Res 2004; 13: 60–8.Google ScholarPubMed
16 Kessler, RC, Ustun, TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004; 13: 93–121.CrossRefGoogle ScholarPubMed
17 Turner, CF, Ku, L, Rogers, SM, Lindberg, LD, Pleck, JH, Sonenstein, FL. Adolescent sexual behaviour, drug use, and violence: increased reporting with computer survey technology. Science 1998; 280: 867–73.CrossRefGoogle ScholarPubMed
18 First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured Clinical Interview for DSM–IV–TR Axis I Disorders, Research Version, Non-Patient Edition (SCID–I/NP). Biometrics Research, New York State Psychiatric Institute, 2002.Google Scholar
19 Kessler, RC, Berglund, P, Demler, O, Jin, R, Walters, EE. Lifetime prevalence and age-of-onset distributions of DSM–IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 593–602.CrossRefGoogle ScholarPubMed
20 Haro, JM, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, ME, Jin, R, Lepine, JP, Mazzi, F, Reneses, B, Vilagut, G, Sampson, NA, Kessler, RC. Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. Int J Methods Psychiatr Res 2006; 15: 167–180.CrossRefGoogle ScholarPubMed
21 Efron, B. Logistic regression, survival analysis, and the Kaplan Meier curve. J Am Sociol Assoc 1988; 83: 414–25.Google Scholar
22 Wolter, K. Introduction to Variance Estimation. Springer-Verlag, 1985.Google Scholar
23 SUDAAN: Professional Software for Survey Data Analysis computer program. 8.0.1 Version. Research Triangle Institute, 2002.Google Scholar
24 Eddleston, M, Konradsen, F. Commentary: time for a re-assessment of the incidence of intentional and unintentional injury in India and South East Asia. Int J Epidemiol 2007; 36: 208–11.CrossRefGoogle ScholarPubMed
25 Brewin, CR, Andrews, B, Gotlib, IH. Psychopathology and early experience: a reappraisal of retrospective reports. Psychol Bull 1993; 113: 82–98.CrossRefGoogle ScholarPubMed
26 Hardt, J, Rutter, M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 2004; 45: 260–73.CrossRefGoogle ScholarPubMed
27 Schlesselman, JJ. Case–Control Studies: Design, Conduct, and Analysis. Oxford University Press, 1982.Google Scholar
28 Kendler, KS, Gallagher, TJ, Abelson, JM, Kessler, RC. Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Arch Gen Psychiatry 1996; 53: 1022–31.CrossRefGoogle Scholar
29 Phillips, MR, Yang, G, Li, S, Li, Y. Suicide and the unique prevalence pattern of schizophrenia in mainland China: a retrospective observational study. Lancet 2004; 364: 1062–8.Google Scholar
30 Cavanagh, JT, Carson, AJ, Sharpe, M, Lawrie, SM. Psychological autopsy studies of suicide: a systematic review. Psychol Med 2003; 33: 395–405.CrossRefGoogle ScholarPubMed
31 Mann, JJ, Waternaux, C, Haas, GL, Malone, KM. Toward a clinical model of suicidal behaviour in psychiatric patients. Am J Psychiatry 1999; 156: 181–9.CrossRefGoogle Scholar
32 Crawford, MJ, Thomas, O, Khan, N, Kulinskaya, E. Psychosocial interventions following self-harm: systematic review of their efficacy in preventing suicide. Br J Psychiatry 2007; 190: 11–7.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Nock et al. supplementary material

Supplementary Material

Download Nock et al. supplementary material(PDF)
PDF 873.7 KB
Supplementary material: File

Nock et al. supplementary material

Supplementary Material

Download Nock et al. supplementary material(File)
File 475 Bytes

This journal is not currently accepting new eletters.

eLetters

No eLetters have been published for this article.