Prevalence of and risk factors for lifetime suicide attempts in the national comorbidity survey

Background: General population survey data are presented on the lifetime pr evalence of suicide attempts as well as transition probabilities to onset o f ideation, plans among ideators, and attempts among ideators either with o r without a plan. Risk factors for these transitions are also studied. Methods: Data are from part II of the National Comorbidity Survey, a nation ally representative survey carried out from 1990 to 1992 in a sample of 587 7 respondents aged 15 to 54 years to study prevalences and correlates of DS M-III-R disorders. Transitions are estimated using life-table analysis. Ris k factors are examined using survival analysis. Results: Of the respondents, 13.5% reported lifetime ideation, 3.9% a plan, and 4.6% an attempt. Cumulative probabilities were 34% for the transition from ideation to a plan, 72% from a plan to an attempt, and 26% from ideati on to an unplanned attempt. About 90% of unplanned and 60% of planned first attempts occurred within 1 year of the onset of ideation. All significant risk factors (female, previously married, age less than 25 years, in a rece nt cohort, poorly educated, and having 1 or more of the DSM-III-R disorders assessed in the survey) were more strongly related to ideation than to pro gression from ideation to a plan or an attempt. Conclusions: Prevention efforts should focus on planned attempts because of the rapid onset and unpredictability of unplanned attempts. More research is needed on the determinants of unplanned attempts.