Cross-national prevalence and risk factors for suicidal ideation, plans and attempts
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Background: Suicide is a leading cause of death worldwide; however, the prevalence and risk factors for the immediate precursors to suicide – suicidal ideation, plans and attempts – are not well-known, especially in low- and middle-income countries. Aims: To report on the prevalence and risk factors for suicidal behaviours across 17 countries. Method: A total of 84 850 adults were interviewed regarding suicidal behaviours and socio-demographic and psychiatric risk factors. Results: The cross-national lifetime prevalence of suicidal ideation, plans, and attempts is 9.2% (s.e.=0.1), 3.1% (s.e.=0.1), and 2.7% (s.e.=0.1). Across all countries, 60% of transitions from ideation to plan and attempt occur within the first year after ideation onset. Consistent cross-national risk factors included being female, younger, less educated, unmarried and having a mental disorder. Interestingly, the strongest diagnostic risk factors were mood disorders in high-income countries but impulse control disorders in low- and middle-income countries. Conclusion: There is cross-national variability in the prevalence of suicidal behaviours, but strong consistency in the characteristics and risk factors for these behaviours. These findings have significant implications for the prediction and prevention of suicidal behaviours.
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Only a third of people who contemplate suicide make an attempt.
“Only a third of people who contemplate suicide make an attempt (Nock et al., 2008), which suggests that there may be critical differences between ideators and attempters (Klonsky and May, 2014).”
From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Nock et al., 2008
In an analysis of World Mental Health Survey data from 17 countries, the reported lifetime prevalence of suicidal ideation was 9.2%, with a lifetime prevalence of suicidal plans of 3.1%.
“For example, in an analysis of World Mental Health Survey data from 17 countries, the reported lifetime prevalence of suicidal ideation was 9.2%, with a lifetime prevalence of suicidal plans of 3.1% 12 .”
From Suicide and suicide risk (2019) · cites this paper as [12]
Rates of suicide attempt are generally higher in females than in males.
“Rates of suicide attempt are generally higher in females than in males 12 , as is the prevalence of anxiety and depression 13 .”
From Suicide and suicide risk (2019) · cites this paper as [12]
The relationship between suicide deaths and nonfatal suicide attempts is closer than the relationship between suicidal ideation and suicide deaths.
“We focused on suicidal behavior as an outcome and not suicidal ideation, because there is closer a relationship between suicide deaths and nonfatal suicide attempts than there is between suicidal ideation and suicide deaths.(7)”
From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [7]
The Prevalence and Characteristics of suicidal behaviours as risk factors sections report attempts among people with suicidal ideation and transitions from ideation to attempts. The Background calls ideation, plans and attempts precursors to suicide, but no passage compares how closely attempts and ideation are related to suicide deaths (searched: suicide deaths, nonfatal attempts, completed suicide). (LLM, conf=0.76)
Experimental — accuracy not yet measuredIndigenous Australian youth have a higher risk of suicide than their non-Indigenous counterparts, with those aged 15 to 24 having about four times the risk and those aged 25 to 34 having almost three times the risk.
“Indigenous Australian youth (aged 15 to 34) have up to four times the risk of suicide compared with their non-Indigenous counterparts.”
From The effectiveness of a suicide prevention app for indigenous Australian youths: study protocol for a randomized controlled trial. (2013) · cites this paper as [2]
The Socio-demographic factors section reports that younger age is associated with suicidal ideation, plans and attempts in a cross-national sample, but it does not compare Indigenous and non-Indigenous Australians or report suicide risk for ages 15–34. Searches for Indigenous Australian youth, the stated age groups and the claimed risk ratios found no passage addressing that comparison. No page number was available for the cited section. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Around 60% of transitions from suicidal ideation to a first suicide attempt occur within a year of ideation onset.
“With around 60% of transitions from suicidal ideation to a first attempt occurring within a year of ideation onset (Nock et al., 2008)”
From From ideation to action: Differentiating between those who think about suicide and those who attempt suicide in a national study of young adults (2018) · cites this paper as Nock et al., 2008
A study based on the 'network approach' found 'sympathetic arousal' to be one of the most central symptoms in the depression network, showing strong connections with other somatic complaints.
“A study based on the 'network approach' 79 also found 'sympathetic arousal' (i.e., palpitations, tremors, blurred vision, sweating) to be one of the most central symptoms in the depression network, showing strong connections with other somatic complaints (limb heaviness, pain, headaches).”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [79]
Suicidal ideation is much more common than suicidal behavior and often does not progress to behavior.
“Suicidal ideation is much more prevalent than suicidal behavior, and it often does not progress to suicidal behavior (15).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [15]
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- Authors
- Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., Bruffaerts, R., Chiu, W. T., de Girolamo, G., Gluzman, S., de Graaf, R., Gureje, O., Haro, J. M., Huang, Y., Karam, E., Kessler, R. C., Lepine, J. P., Levinson, D., Medina-Mora, M. E., Ono, Y., Posada-Villa, J., & Williams, D.
- Affiliations
- Harvard University (US)
- Universidad Autónoma Metropolitana (MX)
- State University of New York (US)
- Hospital del Mar Research Institute (ES)
- Leipzig University (DE)
- University College Hospital, Ibadan (NG)
- Peking University (CN)
- Saint George Hospital (LB)
- Hôpital Fernand-Widal (FR)
- Israel Ministry of Health (IL)
- Keio University (JP)
- Corresponding author
- Nock, Matthew K.
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2008-02
- Volume
- 192
- Issue
- 2
- Pages
- 98-105
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC2259024
- OpenAlex
- W2124058583
- Semantic Scholar
- fedcbbda9713d4875e5ff6c5deb80036f1c195df
- Cited by
- 2,654
- References
- 31
- Citations by year
- 2026: 118 · 2025: 189 · 2024: 199 · 2023: 221 · 2022: 215 · 2021: 278 · 2020: 208 · 2019: 181 · 2018: 197 · 2017: 145 · 2016: 144 · 2015: 147 · 2014: 95 · 2013: 86 · 2012: 80
- FWCI
- 55.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- Robert Wood Johnson Foundation (044708)
- John D. and Catherine T. MacArthur Foundation (R01 DA016558, R13-MH066849)
- John W. Alden Trust (R01-MH069864, R13-MH066849)
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- World Health Organization
- University of Michigan
- European Commission (1999-01042, QLG5–1999-01042, SANCO2004123, 2004123)
- Generalitat de Catalunya (01042, RETICS RD06/0011 REM-TAP)
- Bundesministerium für Gesundheit
- National Insurance Institute of Israel (H13-SHOGAI-023, H16-KOKORO-013, H14-TOKUBETSU-026)
- Ministry of Health, Labour and Welfare (H16-KOKORO-013, H14-TOKUBETSU-026, H13-SHOGAI-023)
- Regione Piemonte (00/0028)
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Substance Abuse and Mental Health Services Administration
- Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849)
- Pan American Health Organization
- Instituto de Salud Carlos III (RETICS RD06/0011 REM-TAP, RETICS RD06/0011, RD06/0011, FIS 00/0028)
- Departament de Salut, Generalitat de Catalunya (RETICS RD06/0011 REM-TAP)
- National Institute of Mental Health (R13-MH-066849, RO1-MH61905, R0 1-MH61905, R01‐MH070884, MH61905, R01MH077883, U01-MH-60220, R01MH061905, R01MH059575, MH60220, MH069864, U13MH066849, MH066849, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558, U01-MH60220)
- Fogarty International Center (FIRCA R01-TW006481, R01-TW006481, R03TW006481)
- Cilag
- 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, suicide risk factors, mood disorders, impulse control disorders, mental illness, low- and middle-income countries, suicide prevention
- MeSH terms
- Adolescent, Adult, Mental Disorders, Female, Humans, International Cooperation, Interview, Psychological, Male, Middle Aged, Risk Factors, Socioeconomic Factors, Suicide, Attempted, Global Health, Prevalence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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