This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (116)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Psychiatry  • Alert me on articles by topic  Social Bookmarking   What's this?

Ronald C. Kessler, PhD; Patricia Berglund, MBA; Guilherme Borges, PhD; Matthew Nock, PhD; Philip S. Wang, MD, DrPH

JAMA. 2005;293:2487-2495.

Context  Little is known about trends in suicidal ideation, plans, gestures, or attempts or about their treatment. Such data are needed to guide and evaluate policies to reduce suicide-related behaviors.

Objective  To analyze nationally representative trend data on suicidal ideation, plans, gestures, attempts, and their treatment.

Design, Setting, and Participants  Data came from the 1990-1992 National Comorbidity Survey and the 2001-2003 National Comorbidity Survey Replication. These surveys asked identical questions to 9708 people aged 18 to 54 years about the past year’s occurrence of suicidal ideation, plans, gestures, attempts, and treatment. Trends were evaluated by using pooled logistic regression analysis. Face-to-face interviews were administered in the homes of respondents, who were nationally representative samples of US English-speaking residents.

Main Outcome Measure  Self-reports about suicide-related behaviors and treatment in the year before interview.

Results  No significant changes occurred between 1990-1992 and 2001-2003 in suicidal ideation (2.8% vs 3.3%; P = .43), plans (0.7% vs 1.0%; P = .15), gestures (0.3% vs 0.2%; P = .24), or attempts (0.4%-0.6%; P = .45), whereas conditional prevalence of plans among ideators increased significantly (from 19.6% to 28.6%; P = .04), and conditional prevalence of gestures among planners decreased significantly (from 21.4% to 6.4%; P = .003). Treatment increased dramatically among ideators who made a gesture (40.3% vs 92.8%) and among ideators who made an attempt (49.6% vs 79.0%).

Conclusions  Despite a dramatic increase in treatment, no significant decrease occurred in suicidal thoughts, plans, gestures, or attempts in the United States during the 1990s. Continued efforts are needed to increase outreach to untreated individuals with suicidal ideation before the occurrence of attempts and to improve treatment effectiveness for such cases.

Author Affiliations: Department of Health Care Policy (Drs Kessler and Wang) and Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital (Dr Wang), Harvard Medical School, Boston, Mass; Institute for Social Research, University of Michigan, Ann Arbor (Ms Berglund); Mexican Institute of Psychiatry, Mexico City, Mexico (Dr Borges); and Department of Psychology, Harvard University, Cambridge, Mass (Dr Nock).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Suicide
Janet M. Torpy, Cassio Lynm, and Richard M. Glass
JAMA. 2005;293(20):2558.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The STAR*D Trial: Revealing the Need for Better Treatments
Insel and Wang
Psychiatr. Serv. 2009;60:1466-1467.
ABSTRACT | FULL TEXT  

Coping With Thoughts of Suicide: Techniques Used by Consumers of Mental Health Services
Alexander et al.
Psychiatr. Serv. 2009;60:1214-1221.
ABSTRACT | FULL TEXT  

Stemming the Tide of Suicide in Older White Men: A Call to Action
Schmutte et al.
Am J Mens Health 2009;3:189-200.
ABSTRACT  

Bipolar Disorder Center for Pennsylvanians: Implementing an Effectiveness Trial to Improve Treatment for At-Risk Patients
Kupfer et al.
Psychiatr. Serv. 2009;60:888-897.
ABSTRACT | FULL TEXT  

Help Seeking and Perceived Need for Mental Health Care Among Individuals in Canada With Suicidal Behaviors
Pagura et al.
Psychiatr. Serv. 2009;60:943-949.
ABSTRACT | FULL TEXT  

Improving Mental Health Treatments Through Comparative Effectiveness Research
Wang et al.
Health Aff (Millwood) 2009;28:783-791.
ABSTRACT | FULL TEXT  

Antecedents and Patterns of Suicide Behavior in First-Admission Psychosis
Bakst et al.
Schizophr Bull 2009;0:sbp001v1-sbp001.
ABSTRACT | FULL TEXT  

Translating Scientific Opportunity Into Public Health Impact: A Strategic Plan for Research on Mental Illness
Insel
Arch Gen Psychiatry 2009;66:128-133.
ABSTRACT | FULL TEXT  

Suicide and Suicidal Behavior
Nock et al.
Epidemiol Rev 2008;30:133-154.
ABSTRACT | FULL TEXT  

Better Off Dead: Suicidal Thoughts in Cancer Patients
Walker et al.
JCO 2008;26:4725-4730.
ABSTRACT | FULL TEXT  

Psychosocial and clinical correlates of suicidal acts: results from a national population survey
Blackmore et al.
Br. J. Psychiatry 2008;192:279-284.
ABSTRACT | FULL TEXT  

Prevalence and correlates of non-fatal suicidal behaviour among South Africans
Joe et al.
Br. J. Psychiatry 2008;192:310-311.
ABSTRACT | FULL TEXT  

Cross-national prevalence and risk factors for suicidal ideation, plans and attempts
Nock et al.
Br. J. Psychiatry 2008;192:98-105.
ABSTRACT | FULL TEXT  

Effect of Regulatory Warnings on Antidepressant Prescribing for Children and Adolescents
Kurian et al.
Arch Pediatr Adolesc Med 2007;161:690-696.
ABSTRACT | FULL TEXT  

Body Mass Index and Risk of Suicide Among Men
Mukamal et al.
Arch Intern Med 2007;167:468-475.
ABSTRACT | FULL TEXT  

Suicide Risk in Childhood Cancer Survivors
Zebrack et al.
JCO 2007;25:732-733.
FULL TEXT  

Reductions in Postdischarge Suicide After Deinstitutionalization and Decentralization: A Nationwide Register Study in Finland
Pirkola et al.
Psychiatr. Serv. 2007;58:221-226.
ABSTRACT | FULL TEXT  

Prevalence of and risk factors for lifetime suicide attempts among blacks in the United States.
Joe et al.
JAMA 2006;296:2112-2123.
ABSTRACT | FULL TEXT  

Individual- and area-level predictors of self-harm repetition
JOHNSTON et al.
Br. J. Psychiatry 2006;189:416-421.
ABSTRACT | FULL TEXT  

Assessment and treatment of depression in patients with cardiovascular disease: national heart, lung, and blood institute working group report.
Davidson et al.
Psychosom. Med. 2006;68:645-650.
ABSTRACT | FULL TEXT  

Suicidal Ideation and Attempts in Adult Survivors of Childhood Cancer
Recklitis et al.
JCO 2006;24:3852-3857.
ABSTRACT | FULL TEXT  

Self-injurious behaviors in a college population.
Whitlock et al.
Pediatrics 2006;117:1939-1948.
ABSTRACT | FULL TEXT  

Suicidal risk in antidepressant drug trials.
Baldessarini et al.
Arch Gen Psychiatry 2006;63:246-248.
FULL TEXT  

Psychiatry as a Clinical Neuroscience Discipline
Insel and Quirion
JAMA 2005;294:2221-2224.
FULL TEXT  

Suicide Prevention Strategies: A Systematic Review
Mann et al.
JAMA 2005;294:2064-2074.
ABSTRACT | FULL TEXT  

Mental Illness and Violent Death: Major Issues for Public Health
Cole and Glass
JAMA 2005;294:623-624.
FULL TEXT  

Mixed Message Seen in Major Study Of Suicide Behavior
Bender
Psychiatr. News 2005;40:8-48.
FULL TEXT