Non-fatal suicidal behavior among South Africans : results from the South Africa Stress and Health Study.
BACKGROUND
Suicide represents 1.8% of the global burden of disease, yet the prevalence and correlates of suicidal behavior in low income countries are unclear. This study examines the prevalence, age of onset and sociodemographic correlates of suicide ideation, planning, and attempts among South Africans.


METHODS
Nationally representative data are from the South Africa Stress and Health Study (SASH), a national household probability sample of 4,351 South African respondents aged 18 years and older conducted between 2002 and 2003, using the World Health Organization version of the composite international diagnostic interview (CIDI). Bivariate and survival analyses were employed to delineate patterns and correlates of nonfatal suicidal behavior. Transitions are estimated using life table analysis. Risk factors are examined using survival analysis.


RESULTS
The risk for attempted suicide is highest in the age group 18-34 and Coloureds had highest lifetime prevalence for attempts. Cumulative probabilities are 43% for the transition from ideation to a plan, 65% from a plan to an attempt, and 12% from ideation to an unplanned attempt. About 7.5% of unplanned and 50% of planned first attempts occur within 1 year of the onset of ideation. South Africans at higher risk for suicide attempts were younger, female, and less educated.


CONCLUSIONS
The burden of nonfatal suicidality in South Africa underscores the need for suicide prevention to be a national priority. Suicide prevention efforts should focus on planned attempts due to the rapid onset and unpredictability of unplanned attempts.
Joe
Sean
S
School of Social Work, University of Michigan, 1080 South University Ave, Room 2780, Ann Arbor, MI 48109, USA. sjoe@ssw.umich.edu
Stein
Dan J
DJ
Seedat
Soraya
S
Herman
Allen
A
Williams
David R
DR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D012308:Risk Management; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D016019:Survival Analysis