Suicide and suicidal behavior

Abstract

Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.

FIGURE 1

Numbers of suicide deaths in the United States, by race/ethnicity, sex, and age group, 2005. Data were obtained from the US Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS) (36). Data points based on fewer than 20 deaths per cell may be unreliable. These include those for persons under age 10 years for all groups, those for persons aged ≥80 years for Black males, those for persons aged 10–14 years and ≥55 years for Black females, those for persons aged 10–14 years and ≥45 years for Native American/Alaskan Native males, and all points except those for persons aged 10–14 years for Native American/Alaskan Native females.

FIGURE 2

Numbers of suicide deaths in the United States, by sex, age group, and year, 1990–2005. Data were obtained from the US Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS) (36).

FIGURE 3

Numbers of suicide deaths in numerous nations, for the most recent year available. Data were obtained from the World Health Organization (8).

FIGURE 4

Rates of nonfatal self-injury in the United States, by sex and age group, 2006. Data were obtained from the US Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS) (37). Data points for persons under age 10 years were based on relatively few cases and may be unreliable.

FIGURE 5

Rates of nonfatal self-injury in the United States, by age group, and year, 2001–2006. Data were obtained from the US Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS) (37).