Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland

Background. Utilizing a prospectively designed community sample, we set out to estimate the rate of newly-incident suicidal ideation and attempts (non -fatal suicide behaviour) in a community sample, to evaluate antecedent soc iodemographic characteristics and psychiatric disorders, and to assess use of mental health services in relation to non-fatal suicide behaviour. Method. Prospectively-gathered data was utilized from 3481 continuing parti cipants in the 13-year follow-up of the Baltimore sample of the NIMH Epidem iologic Catchment Area survey interviewed in 1981, 1982 and 1993/6. Results. The incidence of suicide attempts was estimated at 148.8 per 10000 0 person-years and ideation at 419.9 per 100000 person-years. Persons in th e youngest age group, in the lowest socioeconomic status, and previously ma rried persons were at increased risk for non-fatal suicide behaviour during the follow-up interval. Persons who reported suicidal ideation at baseline were more likely to report having attempted suicide at follow-up (RR = 6.0 9, 95% CI 2.58-14.36). Psychiatric disorders, especially depression and sub stance abuse, were associated with new-onset of non-fatal suicidal behaviou r. While persons who reported newly-incident suicidal behaviour were more l ikely to report use of mental health services, few said that suicidal ideat ion or attempts were the reason for the visits. Conclusions. Suicidal ideation is a common and important antecedent to suic ide attempts and deserves more attention in community and general medical s ettings.