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Non-fatal suicidal behavior among South Africans

Results from the South Africa Stress and Health Study

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Abstract

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.

Method

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.

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Author information

Authors and Affiliations

  1. School of Social Work, University of Michigan, 1080 South University Ave, Room 2780, Ann Arbor, MI, 48109, USA

    Sean Joe MSW, PhD

  2. Dept. of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

    Dan J. Stein MD, PhD (Prof.)

  3. Dept. of Psychiatry, University of Stellenbosch, Cape Town, South Africa

    Soraya Seedat MD (Prof.)

  4. National School of Public Health, Medunsa, South Africa

    Allen Herman MD, PhD

  5. School of Public Health, Harvard University, Boston, MA, USA

    David R. Williams PhD, MPH (Prof.)

Authors
  1. Sean Joe MSW, PhD
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  2. Dan J. Stein MD, PhD
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  3. Soraya Seedat MD
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  4. Allen Herman MD, PhD
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  5. David R. Williams PhD, MPH
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Corresponding author

Correspondence to Sean Joe MSW, PhD.

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Joe, S., Stein, D.J., Seedat, S. et al. Non-fatal suicidal behavior among South Africans. Soc Psychiat Epidemiol 43, 454–461 (2008). https://doi.org/10.1007/s00127-008-0348-7

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  • DOI: https://doi.org/10.1007/s00127-008-0348-7

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