Psychological Medicine

Original Article

Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland

WEN-HUNG  KUO  c1 a1, J. J.  GALLO  a1 and A. Y.  TIEN  a1
a1 From the Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA


Background. Utilizing a prospectively designed community sample, we set out to estimate the rate of newly-incident suicidal ideation and attempts (non-fatal suicide behaviour) in a community sample, to evaluate antecedent sociodemographic characteristics and psychiatric disorders, and to assess use of mental health services in relation to non-fatal suicide behaviour.

Method. Prospectively-gathered data was utilized from 3481 continuing participants in the 13-year follow-up of the Baltimore sample of the NIMH Epidemiologic Catchment Area survey interviewed in 1981, 1982 and 1993/6.

Results. The incidence of suicide attempts was estimated at 148·8 per 100000 person-years and ideation at 419·9 per 100000 person-years. Persons in the youngest age group, in the lowest socio-economic status, and previously married persons were at increased risk for non-fatal suicide behaviour during the follow-up interval. Persons who reported suicidal ideation at baseline were more likely to report having attempted suicide at follow-up (RR = 6·09, 95% CI 2·58–14·36). Psychiatric disorders, especially depression and substance abuse, were associated with new-onset of non-fatal suicidal behaviour. While persons who reported newly-incident suicidal behaviour were more likely to report use of mental health services, few said that suicidal ideation or attempts were the reason for the visits.

Conclusions. Suicidal ideation is a common and important antecedent to suicide attempts and deserves more attention in community and general medical settings.

c1 Address for correspondence: Dr Wen-Hung Kuo, Department of Preventive Medicine and Community Health, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Box 1240, Brooklyn, NY 11203-2098, USA.