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Risk factors for the incidence and persistence of suicide-related outcomes: A 10-year follow-up study using the National Comorbidity Surveys
Open accessAbstract
Background We report prospective associations of baseline risk factors with the first onset and persistence of suicide-related outcomes (SROs; ideation, plans, gestures, and attempts) over a 10-year interval among respondents who participated in both the 1990-02 National Comorbidity Survey (NCS) and the 2000-02 National Comorbidity Survey follow-up (NCS-2).Methods A total of 5001 NCS respondents were re-interviewed (87.6% of baseline sample) in the NCS-2. Three sets of baseline (NCS) risk factors were considered as predictors of the first onset and persistence of SROs: socio-demographics, lifetime DSM-III-R disorders, and SROs.Results New onsets included 6.2% suicide ideation, 2.3% plan, 0.7% gesture, and 0.9% attempts. More than one-third of respondents with a baseline history of suicide ideation continued to have suicide ideation at some time over the intervening decade. Persistence was lower for other SROs. The strongest predictors of later SROs were baseline SROs. Prospective associations of baseline mental disorders with later SROs were largely limited to the onset and persistence of ideation.Limitations Although data were gathered prospectively, they were based on retrospective reports at both baseline and follow-up.Conclusions Baseline history of SROs explained much of the association of mental disorders with later SROs. It is important clinically to note that many of the risk factors known to predict onset of SROs also predict persistence of SROs.
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“the motivation for engaging in suicidal (e.g., intolerance of psychological pain (10); perceived burdensomeness (11)) versus non-suicidal behaviors (e.g., self-punishment (12); social signaling (13)) also may differ, perhaps influencing why NSSI often desists in adulthood (14), whereas STB may persist (15, 16).”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [16]
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Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research
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“Prior suicidal behaviors are among the strongest predictors of subsequent suicidal behaviors (4, 55–57); however, suicide ideation in the continued absence of a plan or attempt is associated with decreasing risk of suicide plans and attempts over time (58).”
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“The finding that every mental disorder measured predicts suicide attempts in bivariate analyses replicates results from prior studies.(11,12,20) Our multivariate analysis showed that the incremental predictive effects of individual disorders are much less powerful and that a general pattern of sub-additive interactive…”
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“Several recent studies have suggested that although mental disorders are strongly predictive of suicide ideation, they are less useful in predicting which people with suicide ideation go on to make suicide plans and attempts [25,26].”
Background
Metadata
- Authors
- Borges, G., Angst, J., Nock, M. K., Ruscio, A. M., & Kessler, R. C.
- Affiliations
- Universidad Autónoma Metropolitana (MX)
- University Hospital Zurich (CH)
- Harvard University (US)
- Corresponding author
- Kessler, Ronald C.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 105
- Issue
- 1-3
- Pages
- 25-33
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC2248274
- OpenAlex
- W2136828172
- Cited by
- 334
- References
- 46
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 10 · 2023: 16 · 2022: 20 · 2021: 21 · 2020: 16 · 2019: 24 · 2018: 17 · 2017: 23 · 2016: 24 · 2015: 21 · 2014: 37 · 2013: 13 · 2012: 25
- FWCI
- 10.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- Substance Abuse and Mental Health Services Administration
- Robert Wood Johnson Foundation (044780)
- National Institute of Mental Health (U01-MH60220)
- John W. Alden Trust
- National Institute on Drug Abuse (DA12058)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- suicidal ideation, suicide planning, suicide attempts, risk factors, mental illness, lifetime psychiatric disorders, National Comorbidity Survey, prospective follow-up
- MeSH terms
- Adolescent, Adult, Mental Disorders, Demography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Risk Factors, Suicide, Suicide, Attempted, Time Factors, United States, Comorbidity, Incidence, Prevalence
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