Researchers studied the trends in suicide attempts over the past 15 years and discovered that the greatest risk is found in younger adults with a history of psychiatric disorders.
Preventing suicide is a public health and research priority. Suicide attempts are the most powerful known risk factor for completed suicide. In fact, approximately 18% of those who attempt suicide will make another attempt within the following year, and between 5% and 10% of adults with serious attempts of suicide have completed suicide within 10 years. This indicates that suicide attempts are important clinical events, and identifying those at risk of suicide attempts is of utmost importance. In spite of efforts to reduce suicide and the rate of suicide attempts, the suicide rate actually increased between 2004 and 2014 from 11to 13per 100,000 people. Researchers want to determine if there is a corresponding increase in the rate of suicide attempts.
Scientists used data from the 2004/2005 and 2012/2013 National Epidemiologic Surveys on Alcohol and Related Conditions (NESARC). These surveys represent face-to-face interviews with 69,341 adult individuals that were conducted by the National Institute on Alcoholism and Alcohol Abuse. The participants were asked a series of detailed questions about their socio-demographic status, medical history, history of violent behaviour, history of psychological disorders, and suicide attempts. The results summarizing the trends in attempts of suicide were recently published in JAMA Psychiatry. The results showed that recent attempts were increasingly prevalent in the 2012/2013 sample when compared to the 2004/2005 sample. The increase was especially pronounced among young adults and those with no more than a high school education. The 2012/2013 survey found that those at the highest risk were those with a history of prior attempts, followed by those with mental disorders including anxiety and depression.
The researchers noticed that women were more likely than men to have a recent suicide attempt (0.92% vs 0.64%). Recent attempts were also correlated with younger adults, being widowed or divorced, lower education, unemployment, lower family income. Each mental disorder was strongly associated with suicide attempts, particularly borderline, schizotypal, and anti-social personality disorders. Prior attempts were also strongly correlated with recent attempts.
Patients with borderline personality disorder were at a particularly high risk of suicide attempts. In fact, both surveys showed that nearly two-thirds of adults with recent attempts of suicide had borderline personality disorder. These patients have previously been found to be at increased risk of completed suicide as well. In fact, “recurrent suicidal behaviour, gestures, or threats” is part of the characterization of borderline personality disorder.
This study shows that the rate of suicide attempts increased from 2004/2005 to 2012/2013. Because attempted suicide is the most reliable predictor of completed suicide this important information may be useful in achieving the clinical goal of reducing suicides. The trends in suicide attempts indicate that clinical efforts should focus on younger, socioeconomically disadvantaged adults with a history of suicide attempts, and personality, mood, and anxiety disorders.
Written by Lisa Borsellino, B.Sc.
Olfson M, Blanco C, Wall M, et al. National Trends in Suicide Attempts Among Adults in the United States. JAMA Psychiatry. 2017 September 15.