Volume 109, Issue 2, Pages 138-147 (February 2010)

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ABSTRACT

ABSTRACT + REFS

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Prevalence of Suicidal Ideation and Associated Risk Factors in the General Population

Received 20 August 2009; received in revised form 6 October 2009; accepted 25 October 2009.

Background/Purpose

Suicide is an important public health problem and one of the leading causes of death worldwide. The present study investigated the prevalence of suicidal ideation (SI) and its associated risk factors in the general population.

Methods

A nationwide community survey was conducted using a computer-aided telephone interview system with residents aged ≥ 15 years, who were selected by a stratified, proportional randomization method. The questionnaire comprised demographic variables, five items of psychopathology selected from the Brief Symptom Rating Scale (BSRS-5) and questions about personal experience with suicide. In total, 2054 respondents, 1002 male (48.8%), and 1052 female (51.2%), completed the survey.

Results

The weighted prevalence of SI was 2.84% in the past week, 5.50% in the past year, and 18.49% during a lifetime. Significant risk factors for SI in the last week included presence of SI over the past year [odds ratio (OR) =1763.6], SI during the lifetime (OR =267.6), psychiatric morbidity (OR = 30.3), depression (OR =26.1), inferiority (OR =11.2), hostility (OR = 10.9), anxiety (OR = 10.5), insomnia (OR =6.7), history of seeking help for psychological distress (OR = 7.9), divorce (OR =6.4), unemployment (OR = 5.0) and having suicidal behavior in relatives or friends (OR =3.8). Stepwise multiple regression analysis demonstrated that the five symptom items of BSRS-5 and unemployment significantly predicted 25.3% of the variance of SI. Using the BSRS-5 score 3 or 4 as a cut-off to predict SI, the rate of accurate classification was 85.88%, with sensitivity of 0.83 and specificity of 0.86.

Conclusion

A telephone interview survey containing the BSRS-5 items is an efficient way to identify determinants of SI in the general population.

Key Words: psychopathology , risk factors , self-rating scale , suicidal ideation

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Article Outline

• Abstract

• References

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References

1. 1 World Health Organization . Revised Global Burden of Disease (GBD) 2002 Estimate . Geneva: World Health Organization; 2002; Available at: http://www.who.int/healthinfo/bodgbd2002revised/en/index.html/ [Date accessed: February 28, 2008] .

2. 2 Department of Health, Executive Yuan, Taiwan . Profile of the Taiwan Region: 10 Leading Causes of Death Structured by Age. 2008 Death Statistics Results Summary, 2008 . Available at: http://www.doh.gov.tw [Access date: October 1, 2009] .

3. 3 Mann JJ , Apter A , Bertolote J , et al. Suicide prevention strategies . JAMA . 2005;294:2064–2074 . CrossRef

4. 4 Suominen K , Isometa E , Suokas J , et al. Completed suicide after a suicide attempt: a 37-year follow-up study . Am J Psychiatry . 2004;161:562–563 . CrossRef

5. 5 Cavanagh JT , Carson AJ , Sharpe M , et al. Psychological autopsy studies of suicide: a systematic review . Psychol Med . 2003;33:395–405 . MEDLINE | CrossRef

6. 6 Kessler RC , Borges G , Walters EE . Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey . Arch Gen Psychiatry . 1999;56:617–626 . CrossRef

7. 7 Neeleman J , DeGraaf R , Vollebergh W . The suicide process: prospective comparison between early and later stages . J Affect Disord . 2004;82:43–52 . Abstract | Full Text | Full-Text PDF (126 KB) | CrossRef

8. 8 Casey PR , Dunn G , Kelly BD , et al. Factors associated with suicidal ideation in the general population: five-centre analysis from the ODIN study . Br J Psychiatry . 2006;189:410–415 . MEDLINE | CrossRef

9. 9 De Leo D , Cerin E , Spathonis K , et al. Lifetime risk of suicide ideation and attempts in an Australian community: prevalence, suicidal process, and help-seeking behaviour . J Affect Disord . 2005;86:215–224 . Abstract | Full Text | Full-Text PDF (131 KB) | CrossRef

10. 10 Baxter D , Appleby L . Case register study of suicide risk in mental disorders . Br J Psychiatry . 1999;175:322–326 . MEDLINE | CrossRef

11. 11 Henriksson MM , Aro HM , Marttunen MJ , et al. Mental disorders and comorbidity in suicide . Am J Psychiatry . 1993;150:935–936 .

12. 12 ten Have M , Vollebergh W , Bijl R , et al. Bipolar disorder in the general population in the Netherlands (prevalence, consequences and care utilisation): results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) . J Affect Disord . 2002;68:203–213 . Abstract | Full Text | Full-Text PDF (108 KB) | CrossRef

13. 13 Sareen J , Houlahan T , Cox BJ , et al. Anxiety disorders associated with suicidal ideation and suicide attempts in the national comorbidity survey . J Nerv Ment Dis . 2005;193:450–454 . MEDLINE | CrossRef

14. 14 Verona E , Sachs-Ericsson N , Joiner TE . Suicide attempts associated with externalizing psychopathology in an epidemiological sample . Am J Psychiatry . 2004;161:444–451 . CrossRef

15. 15 Phillips MR , Yang G , Li S , et al. Suicide and the unique prevalence pattern of schizophrenia in mainland China: a retrospective observational study . Lancet . 2004;364:1062–1068 . Abstract | Full Text | Full-Text PDF (168 KB) | CrossRef

16. 16 Black DW , Warrack G , Winokur G . The Iowa record-linkage study. I. Suicides and accidental deaths among psychiatric patients . Arch Gen Psychiatry . 1985;42:71–75 .

17. 17 Druss B , Pincus H . Suicidal ideation and suicide attempts in general medical illnesses . Arch Intern Med . 2000;160:1522–1526 . MEDLINE | CrossRef

18. 18 Chang HJ , Yang CY , Lin CR , et al. Determinants of suicidal ideation in Taiwanese urban adolescents . J Formos Med Assoc . 2008;107:156–164 . Abstract | Full-Text PDF (209 KB) | CrossRef

19. 19 Lewinsohn PM , Rohde P , Seeley JR . Adolescent suicidal ideation and attempts: prevalence, risk factors, and clinical implications . Clin Psychol . 1996;3:25–46 .

20. 20 Bartle-Haring S , Rosen KH , Stith SM . Emotional reactivity and psychological distress . J Adolesc Res . 2002;17:568–585 .

21. 21 Shaffer D , Scott M , Wilcox H , et al. The Columbia suicide screen: validity and reliability of a screen for youth suicide and depression . J Am Acad Child Adolesc Psychiatry . 2004;43:71–79 . Abstract | Full Text | Full-Text PDF (113 KB) | CrossRef

22. 22 Reynolds WM . Assessment of suicidal ideation in innercity children and young adolescent: reliability and validity of the suicidal ideation questionnaire-JR . School Psych Rev . 1999;17–30 .

23. 23 Lung FW , Lee MB . The five-item Brief-Symptom Rating Scale as a suicide ideation screening instrument for psychiatric inpatients and community residents . BMC Psychiatry . 2008;8:53–60 . CrossRef

24. 24 Cheng TA . A community study of minor psychiatric morbidity in Taiwan . Psychol Med . 1988;18:953–968 . MEDLINE | CrossRef

25. 25 Hwu HG , Yen EK , Chang LY . Prevalence of psychiatric disorders in Taiwan defined by the Chinese diagnostic interview schedule . Acta Psychiatr Scand . 1989;79:136–147 . CrossRef

26. 26 Lue BH , Lee MB , Liang KC . Clinical evaluation of psychiatric disorders among first visit patients to a primary care unit . J Formos Med Assoc . 1990;89:156–161 . MEDLINE

27. 27 Liu SI , Prince M , Blizard B , et al. The prevalence of psychiatric morbidity and its associated factors in general health care in Taiwan . Psychol Med . 2002;32:629–637 . MEDLINE

28. 28 McDermut W , Mattia J , Zimmerman M . Comorbidity burden and its impact on psychosocial morbidity in depressed outpatients . J Affect Disord . 2001;65:289–295 . Abstract | Full Text | Full-Text PDF (65 KB) | CrossRef

29. 29 Lipkin M . Primary care and psychiatry . In: Sadock BJ , Sadock VA editor. Comprehensive Textbook of Psychiatry . Philadelphia: Lippincott Williams & Wilkins; 2000;p. 1923–1935 .

30. 30 Lee MB , Liao SC , Lee YJ , et al. Development and verification of validity and reliability of a short screening instrument to identify psychiatric morbidity . J Formos Med Assoc . 2003;102:687–694 . MEDLINE

31. 31 Chen HC , Wu CH , Lee YJ , et al. Validity of the five-item brief symptom rating scale among subjects admitted for general health screening . J Formos Med Assoc . 2005;104:824–829 . MEDLINE

32. 32 Derogatis LR . The SCL-90-R: Manual I: Scoring, Administration and Procedures for the SCL-90-R: Clinical Psychometric Research . Baltimore: Clinical Psychometric Research; 1977; .

33. 33 Lee MB , Lee YJ , Yen LL , et al. Reliability and validity of using the Brief Psychiatric Symptom Rating Scale in clinical practice . J Formos Med Assoc . 1990;89:1081–1087 . MEDLINE

34. 34 Lee MB , Tai CW , Liao SC , et al. The strategy and prospects of suicide prevention in Taiwan . J Nursing . 2006;53:5–13 .

35. 35 Grunkemeier GL , Jin R . Receiver operating characteristic curve analysis of clinical risk models . Ann Thorac Surg . 2001;72:323–326 . MEDLINE | CrossRef

36. 36 Burless C , De Leo D . Methodological issues in community surveys of suicide ideators and attempters . Crisis . 2001;22:109–124 . MEDLINE | CrossRef

37. 37 Liao SC, Lee MB, Cheng WJ, et al. Prevalence and correlates of suicide ideation, plans, and attempts in Taiwan communities: Results from the national mental health census. In: Proceedings of the 12th Pacific Rim College of Psychiatrist Scientific Meeting, October 2006, Taipei, Taiwan.

38. 38 Scocco P , De Leo D . One-year prevalence of death thoughts, suicide ideation and behaviours in an elderly population . Int J Geriatr Psychiatry . 2002;17:842–846 . MEDLINE | CrossRef

39. 39 Kessler RC , Berglund P , Borges G , et al. Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990-1992 to 2001-2003 . JAMA . 2005;293:2487–2495 . CrossRef

40. 40 Baca-Garcia E , Perez-Rodriguez MM , Keyes KM , et al. Suicidal ideation and suicide attempts in the United States: 1991-1992 and 2001-2002 . Molec Psychiatry . 2008;1–10 .

41. 41 Reinherz HZ , Tanner JL , Berger SR , et al. Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromising functioning at age 30 . Am J Psychiatry . 2006;163:1226–1232 . CrossRef

42. 42 Haatainen KM , Tanskanen A , Kylma J , et al. Stable hopelessness and its predictors in general population: a 2-year follow-up study . Suicide Life Threat Behav . 2003;33:373–380 . MEDLINE | CrossRef

43. 43 Thompson EA , Mazza JJ , Herting JR , et al. The mediating roles of anxiety, depression, and hopelessness on adolescent suicidal behaviors . Suicide Life Threat Behav . 2005;35:14–34 . MEDLINE | CrossRef

44. 44 Chen WJ , Chen CC , Ho CK , et al. The suitability of the BSRS-5 for assessing elderly who have attempted suicide and need to be referred for professional mental health consultation in a metropolitan city, Taiwan . Internat J Geriatr Psychiatry . 2009;24:1151–1157 .

a School of Medicine, Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan

b Departments of Psychiatry and Social Medicine, National Taiwan University and College of Medicine, Taipei, Taiwan

c Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan

d Taiwan Suicide Prevention Center, Department of Health, Chang-Gun Memorial Hospital, Taipei, Taiwan

e Department of Psychiatry, Chang-Gun Memorial Hospital, Taipei, Taiwan

Correspondence to: Dr Ming-Been Lee, Department of Psychiatry, National Taiwan University Hospital, 7 Chung Shan South Road, Taipei, Taiwan

PII: S0929-6646(10)60034-4

doi:10.1016/S0929-6646(10)60034-4

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