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Study Finds Suicide Risk Factors Consistent Across Nations

March - April, 2008  |  Volume 7, Issue 2

Suicide is contemplated by nearly 10 percent of the world's population, although fewer than 3 percent actually make an attempt, according to a Fogarty-supported study published in the British Journal of Psychiatry. The research is the largest examination of the prevalence of suicidal behaviors across numerous countries in order to analyze risk factors.

The study uses data from the WHO's World Mental Health survey, carried out in 17 countries including: Nigeria, South Africa, Colombia, Mexico, U.S., Japan, New Zealand, China, Belgium, France, Germany, Italy, the Netherlands, Spain, Ukraine, Israel and Lebanon. A total of 84,850 adults were asked in face-to-face interviews about suicidal behaviors and socio-demographic and psychiatric risk factors.

The analysis, led by Dr. Matthew Nock of Harvard University, found that risk factors for suicidal thoughts, plans and attempts are consistent across countries and increase sharply during adolescence and young adulthood. Further, it is not just depression that increases the risk of suicidal behaviors across countries--impulse control disorders, substance abuse and anxiety disorders all are associated with a significantly higher risk of suicidal thoughts and attempts. Risk of suicidal behavior is significantly related to being young, female, unmarried, and less well educated, the study found.

Among those interviewed, 9.2 percent reported that they had seriously thought about suicide and 2.7 percent reported making a suicide attempt at some point in their lives. However, there was variation from country to country with regard to the rates of suicidal thoughts and behaviors. Rates of suicidal thoughts ranged from 3.1 percent of people in China to 15.9 percent in New Zealand. A possible reason for this variation may be that different cultural standards exist with regard to the acceptability of telling others about suicidal thoughts. Therefore, among countries with lower rates of suicidal thoughts, it's possible that some thoughts of suicide were not reported.

Among people with suicidal thoughts, 29 percent later made a suicide attempt, and these attempts occurred most often within the first year after the onset of suicidal thoughts. The probability of a suicide attempt among people with both suicidal thoughts and a plan was 56 percent, but only 15.4 percent among those without a plan.

The ability to predict and prevent suicidal thoughts and actions must be improved, the authors say, requiring the continued identification of risk and protective factors that influence such behaviors.

Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, Bruffaerts R, Tat Chiu W, de Girolamo G, Gluzman S, de Graaf R, Gureje O, Haro JM, Huang Y, Karam E, Kessler RC, Lepine JP, Levinson D, Medina-Mora ME, Ono Y, Posada-Villa J, Williams D. The British Journal of Psychiatry, February 2008.

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