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Cited by 26Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseMental Health Treatment and Access

The growth of suicide ideation, plan and attempt among young adults in the Mexico City metropolitan area

Open access
Borges, G., Benjet, C., Orozco, R., Medina-Mora, M-E.·2017·Epidemiology and Psychiatric Sciences
DOI 10.1017/s2045796016000603PMC PMC6999042
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Abstract

Aims.: Low and middle income countries share a heavy burden of suicide with about three in every four suicides occurring in these countries. Mexico has witnessed a growing trend in suicide deaths; if this trend is not simply a reflection of better reporting of suicide on death certificates, then this increase should logically be accompanied by an increasing trend in suicide ideation, plan and attempts, but we lack information on the trends for suicide ideation, plan and attempt for this period. We therefore aim to report changes for suicidal behaviour for the period 2001–2013 in the Mexico City Metropolitan Area. Method.: Using two cross-sectional surveys conducted in Mexico in 2001 and 2013, we report the lifetime and 12-month prevalence of suicide ideation, plan and attempt and changes in treatment for these problems among respondents aged 19–26 living in the Mexico City Metropolitan Area 12 years apart. To estimate the changes in prevalence for each outcome, we used generalised linear models to calculate prevalence ratios (PR; the prevalence rate in the exposed (year 2013) divided by the prevalence rate in the unexposed (year 2001–2002), adjusting for sociodemographic variables. Results.: While increases in the prevalence are noted everywhere, statistical comparisons only found differences for lifetime ideation (PR = 3.1; 95% CI = 1.7–5.8) and a borderline difference for suicide attempt (PR = 2.2; 95% CI = 1.0–4.9). No attempt within the last 12-months was reported in 2001, but the prevalence in 2013 reached 1.5% (18 cases). While PRs for 12-month prevalence were all above the null, none reached statistically significant differences. During this 12-year period, the distribution of mental disorders and the use of services for mental disorders among suicide ideators, planners and attempters did not change in any noticeable way. Conclusions.: The limitations of our data are the small number of participants in the 2001 survey, the low follow-up rate for the survey in 2013 and that while representative from one city it does not represent the whole country. These findings suggest that suicide ideation and attempt may have increased during this 12-year period in the Mexico City metropolitan area, but this increase did not lead to more use of mental health care services. This information, coupled with the long-term trend of increasing suicide death rates in the country, draw a worrisome and neglected scenario for our youth in this region. Urgent measures, following the recent WHO guidelines for suicide prevention, must not be postponed.

Integrity signals

Registry

Crossref · 10.1017/s2045796016000603

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 23 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Lifetime suicide ideation prevalence among 19-26 year olds in the Mexico City Metropolitan Area was about three times higher in 2013 than in 2001-2002, with PR 3.1 (95% CI 1.7-5.8).

    “statistical comparisons only found differences for lifetime ideation (PR = 3.1; 95% CI = 1.7-5.8)”
    • Also stated in: § Results · plain
      “statistical comparisons only found differences for lifetime ideation (a 3 fold increase)”
    Quote in the paperSubstantial claim
  • Findingown data

    Lifetime suicide attempt prevalence among 19-26 year olds in the Mexico City Metropolitan Area was about twice as high in 2013 as in 2001-2002, with a borderline PR 2.2 (95% CI 1.0-4.9).

    “a borderline difference for suicide attempt (PR = 2.2; 95% CI = 1.0-4.9)”
    • Also stated in: § Results · hedged
      “a borderline difference for suicide attempt (a 2 fold increase)”
    Quote in the paperSubstantial claim
  • Findingown data

    The distribution of mental disorders and use of services for mental disorders among suicide ideators, planners, and attempters did not change noticeably over the 12-year period.

    “During this 12-year period, the distribution of mental disorders and the use of services for mental disorders among suicide ideators, planners and attempters did not change in any noticeable way.”
    • Also stated in: § Results · plain
      “During these 12 years, the distribution of mental disorders and the use of services for mental disorders among suicide ideators, planners and attempters did not change in any noticeable way.”
    Quote in the paperSubstantial claim
  • Findingown data

    Pairwise tests of 21 comparisons found no differences in prevalences of mental disorders or service use among suicide ideators, planners, and attempters between 2001 and 2013.

    “Pair-wise tests of all of these comparisons (21 pairs) did not find any differences in these prevalences.”
    Quote in the paperSubstantial claim
  • Findingown data

    Suicide attempt increased among young adults in the Mexico City metropolitan area over the same 12-year period.

    “The evidence presented here suggests that suicide ideation and attempt increased during this 12-year period in the Mexico City metropolitan area, but that this increase did not lead to more use of mental health care services.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 16
  • May combine two claims. 23

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The 2013 sample had more respondents with 10-12 years of education, while the 2001 sample had a larger proportion with some college-level education.

    “the 2013 sample tends to have more years of education up to 10-12 years, while the 2001 sample have a larger proportion of persons with some college-level education.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among respondents with suicide attempt, 69.7% in 2001 used any services, compared with 70.1% in 2013.

    “While 69.7% of attempters in 2001 used any services, this percentage was virtually the same in 2013, 70.1%.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The 2013 sample was more likely to be separated and to have never married than the 2001 sample.

    “The 2013 sample was more likely to be separated and to have never married.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among respondents with suicide attempt, 100% in 2001 had a mental disorder, compared with 85.8% in 2013.

    “among attempters in 2001, 100% had a mental disorder while in 2013 this percentage was 85.8%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among the 18 respondents reporting a suicide attempt in 2013, 50% used a razor, knife, or other sharp instrument, and about 33% had a medical consultation after the attempt.

    “A total of 50% reported using a 'razor, knife or other sharp instrument', and about 33% reported that the attempt lead to a medical consultation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All lifetime and 12-month suicide ideation, plan, and attempt outcomes increased between 2001-2002 and 2013 among 19-26 year olds in the Mexico City Metropolitan Area.

    “all outcomes, both lifetime and 12-month, increased during this 12-year period.”
    • Also stated in: § Abstract · plain
      “While increases in the prevalence are noted everywhere”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Among the 18 respondents reporting a suicide attempt in 2013, 28% described it as a cry for help without intent to die, 33% as an attempt knowing the method was not foolproof, and 39% as a serious attempt.

    “Among the 18 persons that reported in year 2013 a suicide attempt, 28% reported it as a 'Cry for help.Did not intend to die', 33% reported it as a 'Tried to kill his/herself.Knew the method was not foolproof', and the remaining 39% reported it as a 'Serious attempt'.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The 2001 and 2013 samples were similar in sex, age, and occupation distributions.

    “While similar in sex, age and occupation distributions”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For 12-month prevalence, all prevalence ratios were above the null but none reached statistical significance.

    “While PRs for 12-month prevalence were all above the null, none reached statistically significant differences.”
    • Also stated in: § Results · plain
      “While PRs for 12-month prevalence were all above the null, none reached statistically significant differences.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    No 12-month suicide attempt was reported in 2001, while the 2013 prevalence was 1.5% (18 cases).

    “No attempt within the last 12-months was reported in 2001, but the prevalence in 2013 reached 1.5% (18 cases).”
    • Also stated in: § Results · plain
      “While no attempt was reported in 2001, the prevalence in 2013 reached 1.5%.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Study design and conductnone given

    All surveys used the same World Mental Health Composite International Diagnostic Interview and are fully comparable.

    “all surveys used the same WMH-CIDI and are fully comparable.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The few studies on recent trends in suicide ideation and attempts are inconsistent and inconclusive.

    “The few studies, all in other countries, on the existence of increasing recent trends in ideation and attempts are not consistent, nor conclusive”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Kessler et al. 2005

      Not checked in the free run.

    • cites Baca-Garcia et al. 2010

      Not checked in the free run.

    • cites Miret et al. 2014

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The findings suggest that suicide ideation and attempt may have increased during the 12-year period in the Mexico City metropolitan area, but this increase did not lead to more use of mental health care services.

    “These findings suggest that suicide ideation and attempt may have increased during this 12-year period in the Mexico City metropolitan area, but this increase did not lead to more use of mental health care services.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In Mexico, suicide increased 1.25 times between 1990 and 2010 and rose from 21st to 11th place in DALY rankings.

    “between 1990 and 2010 suicide increased 1.25 times and rose from the 21st place to the 11th place in rankings for cause of disability adjusted life years (DALYs)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lozano et al. 2013

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The Mexican National Comorbidity Survey had a response rate of 76.6% for 5782 respondents.

    “The response rate was 76.6% for a total 5782 respondents.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the USA, the overall prevalence of suicide attempts did not differ between 1991 and 2001.

    “while the prevalence of suicide attempts overall did not differ between 1991 and 2001 in the USA (Baca-Garcia et al. 2010)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Baca-Garcia et al. 2010

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The 2013 follow-up had a response rate of 62.0% of located and eligible participants, which was 35.6% of the wave I sample.

    “A response rate of 62.0% of located and eligible participants was obtained, though this was only 35.6% of the wave I sample.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Treatment for mental health disorders in Mexico is limited.

    “treatment for mental health disorders, a key risk factor for suicide, in the country is limited (Borges et al. 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Borges et al. 2006

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Adolescents and young adults are at particularly high risk of suicide deaths and suicide attempts globally and in Mexico.

    “Recent trends show that adolescents and young adults are at particularly high risk of suicide deaths and suicide attempts, globally (World Health Organization, 2014) and in Mexico (Borges et al. 2010b)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites World Health Organization, 2014

      Not checked in the free run.

    • cites Borges et al. 2010b

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The Mexican Adolescent Mental Health Survey had a final sample of 3005 adolescents and a 71% response rate.

    “The final sample included 3005 adolescents, with a 71% response rate.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In Mexico, the number of suicides increased by 10.6% and the suicide death rate increased by 17.1% between 2000 and 2012, while the international suicide death rate decreased by 26%.

    “in Mexico the number of suicides between the years 2000 and 2012 increased by 10.6% and the suicide death rate increased by 17.1%, while at the international level the suicide death rate decreased by 26%”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites World Health Organization, 2014

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The lack of treatment is especially alarming among adolescents suffering from suicidal ideation and attempts.

    “the lack of treatment is especially alarming among adolescents suffering from suicidal ideation and attempts (Borges et al. 2010a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Borges et al. 2010a

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The sample is representative of one city but not the whole country.

    “while representative from one city it does not represent the whole country.”
    • Also stated in: § Discussion · plain
      “The main limitations of our data are the small number of participants in the 19-26 year old age range in the 2001 survey, the low follow-up rate for the survey in 2013 and the fact that while representative from one city it does not represent the whole country.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The reasons for the diversity of findings on suicide trends are not clear.

    “The reasons for this diversity of findings, where trends are stable, upwards or downwards, are not clear and are beyond the goals of our research.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The suicide death rate in Mexico City ranks in the middle among the 31 states, above the national mean, and its rank has been growing within the last 20 years.

    “The suicide death rate in Mexico City, compared with the other 31 states in the country, ranks in the middle, above the national mean suicide death rate (Borges et al. 2015), but this place in the rank has been growing within the last 20 years”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Borges et al. 2015

      Not checked in the free run.

    • cites González-Forteza et al. 2002

      Not checked in the free run.

    • cites Borges & García, 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sociodemographic factors such as sex, age/cohort, education, occupation, and marital status have previously been shown to be related to suicidal behaviour.

    “Sociodemographic factors previously shown to be related to suicidal behaviour (Nock et al. 2008)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nock et al. 2008

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The final sample is not biased for upwards trends, as indicated by the stable suicide plan outcome.

    “The fact that one of our outcomes, suicide plan, did not show signs of increase or decrease during the period, suggests that our final sample is not biased for upwards trends.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study covers only one metropolitan area and one age range, so findings may not apply to other locations or age groups with different risk profiles.

    “While our sample is representative of a large metropolitan area in Mexico, it does not include other cities and other age groups that may differ in risk factors and trends, including availability of mental health services, during this period.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Study design and conductnone given

    There is no evidence that the conclusion about increased suicide ideation and attempt is biased.

    “While limited in precision, there is no evidence that this conclusion is biased.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The same authors reported an increase in suicide attempts among Puerto Ricans and Cubans during 1991-2001.

    “the same authors reported an increase among subgroups, such as Puerto Ricans and Cubans, during this period (Baca-Garcia et al. 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Baca-Garcia et al. 2010

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    If the rising youth suicide death rates in Mexico are real rather than an artifact of improved death certificate reporting, then youth suicidal thoughts, plans, and attempts should also be rising.

    “In Mexico increasing trends in youth suicide fatalities (World Health Organization, 2014) if not simply a reflection of better reporting of suicide on death certificates, should logically be accompanied by an increasing trend in youth ideation, plan and attempts.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites World Health Organization, 2014

      Not checked in the free run.

31 of 31

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Suicide-plan trend is described in opposite ways

    Minor

    The results say that suicide-plan prevalence increased for both lifetime and 12-month measures, but the discussion says suicide plan showed no sign of either an increase or a decrease.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 10

  1. Borges, 2015, La Depresión y otros trastornos psiquiátricos, 313
  2. 2013, Mental Health Action Plan 2013–2020
  3. 2012, SUDAAN Language Manual, Volumes 1 and 2, Release 11
  4. 2013, SUDAAN Statistical Software. Release 11.0.1
  5. Jiménez-Tapia, 2003, Veinticinco años de investigación sobre suicidio y psicosociales del Instituto Nacional de Psiquiatría ‘Ramón de la Fuente’, Salud Mental, 26, 35
  6. Cota, 2009, Estudios sobre conducta suicida en México: 1998–2008, JOVENes, 32, 12
  7. Borges, 2015, Seminario sobre Salud. Padecimientos relacionados con las conductas de riesgo. Módulo 3, 101
  8. Hernández, 2004, Epidemiología del suicidio en el Estado, Salud Mental, 27, 15
  9. Nock, 2012, Suicide: Global Perspective from the WHO World Mental Health Surveys
  10. 2014, Preventing Suicide: A Global Imperative

Cited by

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Related

Authors
Borges, G., Benjet, C., Orozco, R., & Medina-Mora, M.-E.
Affiliations
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
Corresponding author
Borges, G.
ORCID
Venue
Epidemiology and Psychiatric Sciences
Publisher
Cambridge University Press (CUP)
Published
2016-08-15
Volume
26
Issue
6
Pages
635-643
ISSN
  • 2045-7960 (ISSN-L)
  • 2045-7979
DOI
10.1017/s2045796016000603
PMC
PMC6999042
OpenAlex
W2514344965
Cited by
26
References
36
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 8 · 2018: 1 · 2017: 1
FWCI
4.46
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Epidemiology and Psychiatric Sciences (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Pfizer
  • World Health Organization
  • Consejo Nacional de Ciencia y Tecnología (CB-2010-01)
  • Pfizer Foundation
  • Pan American Health Organization
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
suicidal ideation, suicide planning, suicide attempts, young adults, prevalence trends, mental health service utilization, mental illness, Mexico City metropolitan area, low- and middle-income countries, suicide prevention, help-seeking
MeSH terms
Adult, Mental Disorders, Cause of Death, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Mexico, Suicide, Suicide, Attempted, Young Adult, Suicidal Ideation

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