title: Incidence and course of suicidal ideation and suicide attempts in the general population.
abstract: OBJECTIVE
  Suicidal ideation and suicide attempts are important indicators of extreme emotional distress. However, little is known about predictors of onset and course of suicidality in the general population. Our study tried to fill this gap by analyzing data from a prospectively followed community sample.
  
  
  METHODS
  Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a 3-wave cohort study in a representative sample (n = 4848) of the Dutch adult general population.
  
  
  RESULTS
  The 3-year incidence of suicidal ideation and suicide attempts was 2.7% and 0.9%, respectively. Predictors of first-onset suicidal ideation and suicide attempts were sociodemographic variables (especially the negative change in situation variables), life events, personal vulnerability indicators, and emotional (mood and anxiety) disorders. Comparison of the corresponding odds ratios and confidence intervals revealed that predictors for first-onset suicidal ideation and suicide attempts did not differ significantly. One of the strongest predictors of incident suicide attempts was previous suicidal ideation. Regarding the course of suicidal ideation, it was found that 31.3% still endorsed these thoughts and 7.4% reported having made a suicide attempt 2 years later.
  
  
  CONCLUSIONS
  Similar predictors were found for first-onset suicidal ideation and suicide attempts. This suggests that suicidal behaviours may be ordered on a continuum and have shared risk factors. While suicidal thoughts may be necessary for, they are not sufficient predictors of, suicidal acts. The course of suicidality in the general population can be characterized by a minority of people having suicidal experiences that develop over time with progressively increasing severity.
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. mhave@trimbos.nl
authors.forename: Margreet
authors.initials: M
authors.lastname: ten Have
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: Saskia
authors.initials: S
authors.lastname: van Dorsselaer
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Verdurmen
authors.forename: Hedda
authors.initials: H
authors.lastname: van 't Land
authors.forename: Wilma
authors.initials: W
authors.lastname: Vollebergh
authors.forename: Aartjan
authors.initials: A
authors.lastname: Beekman
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009426:Netherlands; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult