title: Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland.
abstract: 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 sociodemographic characteristics and psychiatric disorders, and to assess use of mental health services in relation to non-fatal suicide behaviour.
  
  
  METHODS
  Prospectively-gathered data was utilized from 3481 continuing participants in the 13-year follow-up of the Baltimore sample of the NIMH Epidemiologic Catchment Area survey interviewed in 1981, 1982 and 1993/6.
  
  
  RESULTS
  The incidence of suicide attempts was estimated at 148.8 per 100,000 person-years and ideation at 419.9 per 100,000 person-years. Persons in the youngest age group, in the lowest socioeconomic status, and previously married 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 = 6.09, 95% CI 2.58-14.36). Psychiatric disorders, especially depression and substance abuse, were associated with new-onset of non-fatal suicidal behaviour. While persons who reported newly-incident suicidal behaviour were more likely to report use of mental health services, few said that suicidal ideation or attempts were the reason for the visits.
  
  
  CONCLUSIONS
  Suicidal ideation is a common and important antecedent to suicide attempts and deserves more attention in community and general medical settings.
authors.affiliation: Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Kuo
authors.forename: J J
authors.initials: JJ
authors.lastname: Gallo
authors.forename: A Y
authors.initials: AY
authors.lastname: Tien
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D002391:Catchment Area, Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011446:Prospective Studies; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires