Cross-national prevalence and risk factors for suicidal ideation, plans and attempts.
BACKGROUND
Suicide is a leading cause of death worldwide; however, the prevalence and risk factors for the immediate precursors to suicide - suicidal ideation, plans and attempts - are not wellknown, especially in low- and middle-income countries.


OBJECTIVE
To report on the prevalence and risk factors for suicidal behaviours across 17 countries.


METHODS
A total of 84 850 adults were interviewed regarding suicidal behaviours and socio-demographic and psychiatric risk factors.


RESULTS
The cross-national lifetime prevalence of suicidal ideation, plans, and attempts is 9.2% (s.e.=0.1), 3.1% (s.e.=0.1), and 2.7% (s.e.=0.1). Across all countries, 60% of transitions from ideation to plan and attempt occur within the first year after ideation onset. Consistent cross-national risk factors included being female, younger, less educated, unmarried and having a mental disorder. Interestingly, the strongest diagnostic risk factors were mood disorders in high-income countries but impulse control disorders in low- and middle-income countries.


CONCLUSIONS
There is cross-national variability in the prevalence of suicidal behaviours, but strong consistency in the characteristics and risk factors for these behaviours. These findings have significant implications for the prediction and prevention of suicidal behaviours.
Nock
Matthew K
MK
Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA. nock@wjh.harvard.edu
Borges
Guilherme
G
Bromet
Evelyn J
EJ
Alonso
Jordi
J
Angermeyer
Matthias
M
Beautrais
Annette
A
Bruffaerts
Ronny
R
Chiu
Wai Tat
WT
de Girolamo
Giovanni
G
Gluzman
Semyon
S
de Graaf
Ron
R
Gureje
Oye
O
Haro
Josep Maria
JM
Huang
Yueqin
Y
Karam
Elie
E
Kessler
Ronald C
RC
Lepine
Jean Pierre
JP
Levinson
Daphna
D
Medina-Mora
Maria Elena
ME
Ono
Yutaka
Y
Posada-Villa
José
J
Williams
David
D
D000293:Adolescent; D000328:Adult; D005260:Female; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013406:Suicide, Attempted / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data