Suicidal ideation and suicide attempts in general medical illnesses

Background: This study examines the association between the presence of a g eneral medical illness and suicidality in a representative sample of US you ng adults. Methods: Between 1988 and 1994, 7589 individuals aged 17 to 39 years were a dministered the Diagnostic Interview Schedule as part of a national probabi lity survey. The survey collected information about lifetime suicidal ideat ion and suicide attempts, a checklist of common general medical conditions, and data on major depression, alcohol use, and demographic characteristics . Results: Whereas 16.3% of respondents described suicidal ideation at some p oint in their lives, 25.2%, of individuals with a general medical condition , and 35.0% of those with 2 or more medical illnesses reported lifetime sui cidal ideation. Similarly, whereas 5.5% of respondents had made a suicide a ttempt, 8.9% of those with a general medical illness and 16.2%;, of those w ith 2 or more medical conditions had attempted suicide. In models controlli ng for major depression, depressive symptoms, alcohol use, and demographic characteristics, presence of a general medical condition predicted a 1.3 ti mes increase in likelihood of suicidal ideation; more specifically, pulmona ry diseases (asthma, bronchitis) were associated with a two-thirds increase in the odds of lifetime suicidal ideation. Cancer and asthma were each ass ociated with a more than 4-fold increase in the likelihood of a suicide att empt. Conclusions: A significant association was found between medical conditions and suicidality that persisted after adjusting for depressive illness and alcohol use. The findings support the need to screen for suicidality in gen eral medical settings, over and above use of general depression instruments .