Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys
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OBJECTIVE: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. METHOD: Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including sociodemographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. RESULTS: Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). CONCLUSIONS: Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors.
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The costs were mainly due to lost productivity.
“Of note, the costs were mainly due to lost productivity 337 .”
From Suicide and suicide risk (2019) · cites this paper as [337]
The Introduction and Results discuss suicide attempts, their consequences, prevalence, and risk factors, but do not assess their economic costs. Searches for lost productivity and indirect costs found no passage establishing that lost productivity accounted for most costs. (LLM, conf=0.76)
Experimental — accuracy not yet measuredKnown risk factors for suicide, including psychiatric and demographic variables such as depression, gender and stress, are poor predictors of short-term suicidal behavior or are non-modifiable.
“However, these factors have quite limited clinical use: they are poor predictors of short-term behavior, or are non-modifiable (e.g., gender, past STBs).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [28]
Suicide and suicide-related phenomena represent a major cause of mortality and disability worldwide.
“Suicide and suicide-related phenomena [ideation i.e., thoughts or fantasies about one's death (27), attempts] represent a major cause of mortality and disability worldwide (28, 29).”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [28]
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- Authors
- Borges, G., Nock, M. K., Haro Abad, J. M., Hwang, I., Sampson, N. A., Alonso, J., Andrade, L. H., Angermeyer, M. C., Beautrais, A., Bromet, E., Bruffaerts, R., de Girolamo, G., Florescu, S., Gureje, O., Hu, C., Karam, E. G., Kovess-Masfety, V., Lee, S., Levinson, D., Medina-Mora, M. E., Ormel, J., Posada-Villa, J., Sagar, R., Tomov, T., Uda, H., Williams, D. R., & Kessler, R. C.
- Affiliations
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- Harvard University (US)
- Hospital Del Mar (ES)
- Universidade de São Paulo (BR)
- Christchurch Hospital (NZ)
- State University of New York (US)
- Universitair Ziekenhuis Leuven (BE)
- National School of Public Health, Management and Professional Development (RO)
- University College Hospital, Ibadan (NG)
- Shenzhen KangNing Hospital (CN)
- St George’s University Hospitals NHS Foundation Trust (GB)
- Chinese University of Hong Kong (HK)
- Israel Ministry of Health (IL)
- University Medical Center Groningen (NL)
- All India Institute of Medical Sciences (IN)
- New Bulgarian University (BG)
- Osumi Regional Promotion Bureau (JP)
- Corresponding author
- Kessler, Ronald C.
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2010-08-24
- Volume
- 71
- Issue
- 12
- Pages
- 1617-1628
- ISSN
- 0160-6689 (ISSN-L)
- PMC
- PMC3000886
- OpenAlex
- W2122210770
- Cited by
- 796
- References
- 77
- Citations by year
- 2026: 36 · 2025: 37 · 2024: 67 · 2023: 58 · 2022: 71 · 2021: 75 · 2020: 75 · 2019: 58 · 2018: 52 · 2017: 52 · 2016: 49 · 2015: 60 · 2014: 41 · 2013: 35 · 2012: 20
- FWCI
- 22.22
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- other-oa
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (acceptedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- John D. and Catherine T. MacArthur Foundation (R01 DA016558, R13-MH066849)
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- World Health Organization
- European Commission (QLG5–1999-01042, SANCO2004123, 2004123)
- Fundação de Amparo à Pesquisa do Estado de São Paulo (03/00204-3, 03/00204?)
- Generalitat de Catalunya (01042)
- Ministerio de Ciencia y Tecnología (SAF 2000 158-CE)
- Regione Piemonte (00/0028)
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849, R03-TW006481)
- Pan American Health Organization
- Instituto de Salud Carlos III (CB06/02/0046, CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP, RETICS RD06/0011, RD06/0011, FIS 00/0028, CIBER CB06/02/0046)
- Departament de Salut, Generalitat de Catalunya
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, R01MH077883, R01MH061905, R01MH059575, U13MH066849, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558)
- Fogarty International Center (FIRCA R03TW006481, R03TW006481)
- 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
- suicide attempts, suicidal ideation, suicide planning, 12-month prevalence, risk factors, risk index, suicide risk prediction, developed and developing countries, childhood adversity, parental psychopathology, unemployment, socioeconomic status, mental illness, sex differences
- MeSH terms
- Adult, Age Factors, Aged, Mental Disorders, Developing Countries, Female, Health Surveys, Humans, International Cooperation, Male, Mental Health, Middle Aged, Parents, Risk Factors, Sex Factors, Social Class, Suicide, Attempted, Global Health, World Health Organization, Comorbidity, Prevalence, Epidemiologic Studies, Developed Countries, Diagnostic and Statistical Manual of Mental Disorders, Suicidal Ideation
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.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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