Wednesday, September 13, 2017

Increase in Suicide Attempts Appears Driven By Young Adults With Less Formal Education, Psychiatric Disorders

An overall increase in suicide attempts from 2004-2005 to 2012-2013 appears to have disproportionately affected younger adults with less formal education and those with antisocial personality disorder, anxiety disorders, depressive disorders, and a history of violence, according to a report published today in JAMA Psychiatry.

Borderline personality disorder (BPD) continues to be the disorder most associated with suicide attempt risk, but the percentage of individuals with BPD attempting suicide dropped during the period of analysis, possibly suggesting increased access to evidence-based treatments.

Lead author Mark Olfson, M.D., M.P.H. (pictured above), of Columbia University and colleagues noted that because attempted suicide is the greatest known risk factor for completed suicide, reducing suicide attempts is an important public health and clinical goal. “The trends revealed in the study support a clinical and public health focus on young, socioeconomically disadvantaged adults, especially those who have made previous suicide attempts and those who have common mood, anxiety, and personality disorders,” he told Psychiatric News.

Olfson and colleagues used data from the 2004-2005 wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the 2012-2013 NESARC-III. These nationally representative surveys asked identical questions to 69,341 adults, aged 21 years and older, concerning the occurrence and timing of suicide attempts.

During the study period, the percentage of U.S. adults who reported making a recent suicide attempt increased from 0.62% in 2004-2005 to 0.79% in 2012-2013. In both surveys, most adults with recent suicide attempts were female (60.17% and 60.94% for the two periods, 2004-2005 and 2012-2013, respectively) and younger than 50 years (84.75% and 80.38%, respectively).

Statistical analysis showed significantly higher risk of suicide attempt among adults aged 21 to 34 years than among adults aged 65 and older; adults with no more than a high school education than among college graduates; and adults with antisocial personality disorder, a history of violent behavior, or a history of anxiety or depressive disorders than among adults without these conditions.

“Although we don’t understand all of the factors that are driving these trends, it may be that younger adults and adults with less education have been especially hard hit by the recent recession in terms of economic and psychological stress,” Olfson said. “Unemployed adults, those with less education, and adults with lower family incomes were all especially likely to report a recent suicide attempt.”

He called the decrease in the percentage of individuals with BPD reporting recent suicide attempt a bright spot in the study. In 2004-2005, 6.9% of adults with BPD made a suicide attempt compared with 4.57% in 2012-2013.

“This may be in part because more psychiatrists and other mental health professionals are being trained to deliver dialectical behavioral therapy,” Olfson said. 

For related information, see the Psychiatric News article “Netflix Drama About Teen Suicide Prompts Related Google Searches.”

(Image: courtesy Mark Olfson, M.D., M.P.H.) 


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