Abstract
This research aims to explore whether sex, race, age, education, and marital status can significantly predict suicide ideation (SI) and suicidal attempts (SA) among adults with and without MDE; and to examine whether the association between MDE, SI, and SA changes after adjusting for age, education, and marital status as confounding factors while keeping race-sex as a constant variable. To reach this goal, data from the 2018 National Survey on Drug Use and Health were extracted and analyzed, producing 42,551 records. Study results show that among adults with MDE, adults <50 years old, adults without a college degree, never married, divorced/separated, and White males were at increased risk for SI. Among adults without MDE, adults<50, with some college education, never married, or divorced/separated were more likely to experience SI. Black males were at increased risk for SA, whether they had MDE or not. There is a diverse at-risk population for SI and SA among adults with and without MDE. Special attention should be paid to Black males.
Similar content being viewed by others
References
Laursen TM, Munk-Olsen T, Nordentoft M, Mortensen PB. Increased mortality among patients admitted with major psychiatric disorders: a register-based study comparing mortality in unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder, and schizophrenia. J Clin Psychiatry. 2007;68(6):899–907.
Laursen TM, Musliner KL, Benros ME, Vestergaard M, Munk-Olsen T. Mortality and life expectancy in persons with severe unipolar depression. J Affect Disord. 2016;193:203–7. https://doi.org/10.1016/j.jad.2015.12.067.
Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 2016;316(21):2214–36. https://doi.org/10.1001/jama.2016.17324.
Liu C, Wang L, Qi R, Wang W, Jia S, Shang D, et al. Prevalence and associated factors of depression and anxiety among doctoral students: the mediating effect of mentoring relationships on the association between research self-efficacy and depression/anxiety. Psychol Res Behav Manag. 2019;12:195–208. https://doi.org/10.2147/prbm.S195131.
Gill SK, Munoz RF, Leykin Y. The influence of perceived stress and depression on suicide-related beliefs in Caucasian and Indian adults. Crisis. 2018;39(2):127–36. https://doi.org/10.1027/0227-5910/a000492.
National center for injury prevention and control. Web-based injury statistics query and reporting system 2015.
Large M. Study on suicide risk assessment in mental illness underestimates inpatient suicide risk. BMJ. 2016;532:i267. https://doi.org/10.1136/bmj.i267.
Omary A. National prevalence and demographic correlates of suicidal ideation and suicide attempts in adults with and without major depression 2020.
Center for Behavioral Health Statistics and Quality. Results from the 2017 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: Office of Applied Studies, Substance Abuse and Mental Health Services Administration.; 2018.
American_Foundation_for_Suicide_Prevention. Suicide Claims More Lives Than War, Murder, And Natural Disasters Combined. 2016. https://www.theovernight.org/index.cfm?fuseaction=cms.page&id=
Joe S, Baser RE, Breeden G, Neighbors HW, Jackson JS. Prevalence of and risk factors for lifetime suicide attempts among blacks in the United States. JAMA. 2006;296(17):2112–23. https://doi.org/10.1001/jama.296.17.2112.
Park-Lee E, Hedden, S. L., & Lipari, R. N. Suicidal Thoughts and Behavior in 33 Metropolitan Statistical Areas Update: 2013 to 2015. Substance Abuse and Mental Health Services Administration (US); 2013. p. 1–10.
Suominen K, Isometsä E, Suokas J, Haukka J, Achte K, Lönnqvist J. Completed suicide after a suicide attempt: a 37-year follow-up study. Am J Psychiatry. 2004;161(3):562–3.
Rendall MS, Weden MM, Favreault MM, Waldron H. The protective effect of marriage for survival: a review and update. Demography. 2011;48(2):481–506. https://doi.org/10.1007/s13524-011-0032-5.
Masocco M, Pompili M, Vichi M, Vanacore N, Lester D, Tatarelli R. Suicide and marital status in Italy. Psychiatry Q. 2008;79(4):275–85. https://doi.org/10.1007/s11126-008-9072-4.
Akbarizadeh F, Hajivandi A, Hajivandi M, Zeidabadinejad MS. Marriage related suicide fatality rates. Iran J Psychiatry. 2019;14(1):54–9.
Bálint L, Osváth P, Rihmer Z, Döme P. Associations between marital and educational status and risk of completed suicide in Hungary. J Affect Disord. 2016;190:777–83. https://doi.org/10.1016/j.jad.2015.11.011.
Mirowsky J, Ross CE. Age and the effect of economic hardship on depression. J Health Soc Behav. 2001;42(2):132–50. https://doi.org/10.2307/3090174.
von dem Knesebeck O, Pattyn E, Bracke P. Education and depressive symptoms in 22 European countries. Int J Public Health. 2011;56(1):107–10. https://doi.org/10.1007/s00038-010-0202-z.
Marty MA, Segal DL, Coolidge FL. Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults. Aging Ment Health. 2010;14(8):1015–23. https://doi.org/10.1080/13607863.2010.501068.
Draper BM. Suicidal behaviour and suicide prevention in later life. Maturitas. 2014;79(2):179–83. https://doi.org/10.1016/j.maturitas.2014.04.003.
St John PD, Montgomery PR. Marital status, partner satisfaction, and depressive symptoms in older men and women. Can J Psychiatr. 2009;54(7):487–92. https://doi.org/10.1177/070674370905400710.
Quality. CfBHSa. 2018 National Survey on Drug Use and Health Public Use File Codebook. Rockville, MD.: Substance Abuse and Mental Health Administration.; 2019.
Substance Abuse and Mental Health Services Administration. Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health,. Rockville, MD: Center for Behavioral Health Statistics and Quality, 2019. Report No.: HHS Publication No. PEP19–5068, NSDUH Series H-54.
Center for Behavioral Health Statistics and Quality. 2018 National Survey on drug use and health: methodological resource book (section 2, sample design report). Rockville: Substance Abuse and Mental Health Services Administration; 2019.
Harrell F. Regression modeling strategies: with applications to linear models, logistic and ordinal regression, and survival analysis. New York: Springer; 2015.
Crosby AE, Han B, Ortega LA, Parks SE, Gfroerer J. Suicidal thoughts and behaviors among adults aged ≥18 years--United States, 2008–2009. Morbidity and Mortality Weekly Report. 2011/10/21 ed2011. p. 1–22.
Heisel MJ, Flett GL. Psychological resilience to suicide ideation among older adults. Clin Gerontol. 2008;31(4):51–70. https://doi.org/10.1080/07317110801947177.
Bilsker D, White J. The silent epidemic of male suicide. B C Med J. 2011;53(10):529–34.
O'Donnell S, Richardson N. Suicide and engaging men in Ireland-middle-aged men a problem or the symptom of a problem? . Eur J Public Health. 2017;27(suppl_3). https://doi.org/10.1093/eurpub/ckx186.252.
Houle J, Mishara BL, Chagnon F. An empirical test of a mediation model of the impact of the traditional male gender role on suicidal behavior in men. J Affect Disord. 2008;107(1):37–43. https://doi.org/10.1016/j.jad.2007.07.016.
Rogers ML, Ringer FB, Joiner TE. The association between suicidal ideation and lifetime suicide attempts is strongest at low levels of depression. Psychiatry Res. 2018;270:324–8. https://doi.org/10.1016/j.psychres.2018.09.061.
Miller S, Segal DL, Frederick L, Coolidge J. A comparison of suicidal thinking and reasons for living among younger and older adults. Death Stud. 2001;25(4):357–65. https://doi.org/10.1080/07481180151143105.
Nisbet PA. Protective factors for suicidal black females. Suicide Life Threat Behav. 1996;26(4):325–41. https://doi.org/10.1111/j.1943-278X.1996.tb00836.x.
Oquendo MA, Dragatsi D, Harkavy-Friedman J, Dervic K, Currier D, Burke AK et al. Protective factors against suicidal behavior in Latinos. J Nerv Ment Dis. 2005;193(7).
Silva C, Van Orden KA. Suicide among Hispanics in the United States. Curr Opin Psychol. 2018;22:44–9. https://doi.org/10.1016/j.copsyc.2017.07.013.
Han B, Compton WM, Gfroerer J, McKeon R. Prevalence and correlates of past 12-month suicide attempt among adults with past-year suicidal ideation in the United States. J Clin Psychol. 2015;76(3):295–302. https://doi.org/10.4088/JCP.14m09287.
Fortuna LR, Perez DJ, Canino G, Sribney W, Alegria M. Prevalence and correlates of lifetime suicidal ideation and suicide attempts among Latino subgroups in the United States. J Clin Psych. 2007;68(4):572–81. https://doi.org/10.4088/jcp.v68n0413.
Goodwill JR, Taylor RJ, Watkins DC. Everyday discrimination, depressive symptoms, and suicide ideation among African American men. Arch Suicide Res. 2019:1–20. https://doi.org/10.1080/13811118.2019.1660287.
Pathak EB. Mortality among black men in the USA. J Racial Ethnic Health Dis. 2018;5(1):50–61. https://doi.org/10.1007/s40615-017-0341-5.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Author Areen Omary declares that she has no conflict of interest.
Ethical Approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Omary, A. Predictors and Confounders of Suicidal Ideation and Suicide Attempts among Adults with and without Depression. Psychiatr Q 92, 331–345 (2021). https://doi.org/10.1007/s11126-020-09800-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11126-020-09800-y