Psychological factors associated with the incidence and persistence of suicidal ideation

J Affect Disord. 2011 Oct;133(3):584-90. doi: 10.1016/j.jad.2011.05.003. Epub 2011 Jun 1.


Background: Suicidal ideation has been identified as both a common antecedent and a significant risk factor for suicide attempt and completed suicide. However, little is known about the incidence and persistence of suicidal ideation in the general population and the associated risk factors.

Methods: A 12-month follow-up survey investigated 997 of the respondents who participated in the baseline territory-wide survey of adult population in Hong Kong. A set of baseline psychological factors was considered as predictors of first onset and persistence of suicidal ideation.

Results: Twelve-month incidence (1.9%) and persistence (6.2%) rates were estimated. Respondents with anxiety and lack of reasons for living were more likely to report a development of suicidal thoughts in the follow-up assessment, while respondents with higher level of average life distress and lower level of hope were at increased risk of continuing to have suicidal thoughts. Depression was found to partially mediate the effect of average life distress on persistent suicidality.

Limitations: Retention rate of the follow-up sample was about 50% only. Assessments of suicidal ideation were based on retrospective reports.

Conclusions: Psychological factors differentially predict first onset and persistence of suicidal ideation. It is of clinical value that depression partially mediated the effect of life distress on persistence of suicidality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Anxiety*
  • Cohort Studies
  • Data Collection
  • Depression / epidemiology
  • Depression / psychology
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Follow-Up Studies
  • Hong Kong / epidemiology
  • Humans
  • Incidence
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Middle Aged
  • Retrospective Studies
  • Risk
  • Risk Factors
  • Stress, Psychological*
  • Suicidal Ideation*
  • Suicide / psychology*
  • Suicide / statistics & numerical data
  • Suicide, Attempted / psychology
  • Suicide, Attempted / statistics & numerical data