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Suicide attempts increased nationally from 2004 to 2013
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Analysis of national data indicated an overall increase in suicide attempts among adults in the United States, particularly younger adults, and those with a lower level of education and anxiety, depressive and antisocial personality disorders.
“Preventing suicide is a leading public health and research priority. However, despite policy and clinical initiatives aimed at reducing suicide, the rate of suicide in the United States increased by approximately 2% per year from 2006 to 2014,” Mark Olfson, MD, MPH, of Columbia University, New York, and colleagues wrote. “One recognized approach to preventing suicide involves improving the identification and treatment of individuals at high risk, including those who plan or attempt suicide.”
To determine trends in recent suicide attempts in the United States, researchers analyzed data from wave 2 of the 2004 to 2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the 2012 to 2013 NESARC-III. The study cohort included 69,341 individuals with a mean age of 48.1 years.
The weighted percentage of adults with a recent suicide attempt increased from 0.62% in 2004 to 2005 to 0.79% in 2012 to 2013 (P = .04).
Most participants with recent suicide attempts were female (2004-2005, 60.17%; 2012-2013, 60.94%) and aged younger than 50 years (2004-2005, 84.75%; 2012-2013, 80.38%).
Adjusted risk difference for suicide attempts was significantly higher among participants aged 21 to 34 years compared with participants aged 65 years and older (0.48% vs. 0.06%; P = .04).
Adjusted risk difference for suicide attempts was significantly greater among participants with no more than a high school education compared with college graduates (0.49% vs. 0.03%; P = .003).
Further, participants with antisocial personality disorder (2.16% vs. 0.07%; P = .01), a history of violent behavior (1.04% vs. 0%; P = .003), or a history of anxiety (1.43% vs. 0.18%; P = .01) or depressive (0.99% vs. –0.08%; P = .05) disorders had greater adjusted risk differences for suicide attempt compared with participants without these conditions.
In an accompanying editorial, Eric D. Caine, MD, of the Injury Control Research Center for Suicide Prevention, University of Rochester Medical Center, Rochester, New York, reflected on the public health impact of these findings.
“The surveys on which this study was based occurred in communities rather than in clinical settings. It is essential now to build public health approaches to preventing suicide, attempted suicides, risk-related premature deaths, and their antecedent adversities under an umbrella of public health and preventive psychiatry,” he wrote. “For most men and many of the women in the National Violent Death Reporting System data examined by Stone et al., their death was their first attempt. Given the cumulative frequency of family, legal and financial problems, it behooves us to look beyond the walls of our clinics and offices to engage vulnerable individuals and families in diverse settings such as courts and jails, social service agencies, and perhaps the streets long before they have become ‘suicidal.’” – by Amanda Oldt
Disclosures: The authors report no relevant financial disclosures.
Perspective
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C. David Nicholson, PhD
The new publication by Olfson and colleagues provides important epidemiological analyses on suicide attempts in the United States. Based on survey data from a total of 69,341 participants collected in wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) in 2004-2005 and from NESARC-III in 2012-13, the published results demonstrate an increase of suicide attempts among adults in the U.S.
In line with previously published data reporting on increased suicide in the U.S., these data again reinforce the major public health concern of suicide and the urgent need for effective interventions for individuals at risk. Importantly, the results show a particularly alarming increase of suicide attempts in certain U.S. adult populations — including young male adults with less formal education, as well as people with mental health issues, such as depression, anxiety or certain personality disorders.
For us at Allergan, we take these new findings as further reinforcement as to why we are so committed to investing in research to develop and provide new treatment options for patients living with mental illness, including individuals with depression and acute suicidality.
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