Jia-Chi Shan1,2,3, I-Ming Chen2, Po-Hsien Lin2,4, Wei J Chen5,6, Shih-Cheng Liao7, Ming-Been Lee8,9, Po-Hsiu Kuo2,10. 1. Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan. 2. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan. 3. School of Medicine, National Tsing Hua University, Hsinchu, Taiwan. 4. Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan. 5. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan. wjchen@ntu.edu.tw. 6. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan. wjchen@ntu.edu.tw. 7. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan. scliao@ntu.edu.tw. 8. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan. mingbeen@ntu.edu.tw. 9. Department of Psychiatry, Shin Kong Wu Ho Su Hospital, Taipei, Taiwan. mingbeen@ntu.edu.tw. 10. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
Abstract
BACKGROUND: East Asia has high suicide rates but low prevalence of mental disorders. We examined the associations between prior lifetime mental disorders (mood disorders, anxiety disorders, substance use disorders, and impulse control disorders) and subsequent suicidal behaviors (suicidal ideation and attempts in the general population and suicide plans, planned attempts, and unplanned attempts in suicidal ideators) in Taiwan. METHODS: This survey applied the World Mental Health Survey Composite International Diagnostic Interview to a population representative sample of noninstitutionalized adults between 2003 and 2005. Odds ratios (ORs) obtained using discrete-time survival analysis were used to estimate population attributable fractions (PAFs) of suicidal behaviors due to lifetime mental disorders. RESULTS: Lifetime mental illness was a significant risk factor for subsequent suicidal behaviors (except unplanned attempts among ideators) despite the relatively low prevalence of mental disorders in people with suicidality (16.1%-35.0%). Each diagnosis increased the odds of suicidal ideation. In terms of acting on suicidal ideation, mood disorders were most strongly associated with having plans (OR = 10.0; 95% confidence interval, CI 4.3-21.1), whereas substance use disorders most strongly with either planned (OR = 27.3; 95% CI 6.3-118.5) or unplanned attempts (OR = 14.5; 95% CI 1.7-121.5). PAFs of all mental disorders on suicidality lay between 20 and 30% (except 11% of unplanned attempts among ideators). Mood, anxiety, and substance use disorders had higher PAFs than impulse control disorders. CONCLUSIONS: In addition to mood disorders, considering anxiety and substance use disorders is essential in devising population-based suicide prevention strategies.
BACKGROUND: East Asia has high suicide rates but low prevalence of mental disorders. We examined the associations between prior lifetime mental disorders (mood disorders, anxiety disorders, substance use disorders, and impulse control disorders) and subsequent suicidal behaviors (suicidal ideation and attempts in the general population and suicide plans, planned attempts, and unplanned attempts in suicidal ideators) in Taiwan. METHODS: This survey applied the World Mental Health Survey Composite International Diagnostic Interview to a population representative sample of noninstitutionalized adults between 2003 and 2005. Odds ratios (ORs) obtained using discrete-time survival analysis were used to estimate population attributable fractions (PAFs) of suicidal behaviors due to lifetime mental disorders. RESULTS: Lifetime mental illness was a significant risk factor for subsequent suicidal behaviors (except unplanned attempts among ideators) despite the relatively low prevalence of mental disorders in people with suicidality (16.1%-35.0%). Each diagnosis increased the odds of suicidal ideation. In terms of acting on suicidal ideation, mood disorders were most strongly associated with having plans (OR = 10.0; 95% confidence interval, CI 4.3-21.1), whereas substance use disorders most strongly with either planned (OR = 27.3; 95% CI 6.3-118.5) or unplanned attempts (OR = 14.5; 95% CI 1.7-121.5). PAFs of all mental disorders on suicidality lay between 20 and 30% (except 11% of unplanned attempts among ideators). Mood, anxiety, and substance use disorders had higher PAFs than impulse control disorders. CONCLUSIONS: In addition to mood disorders, considering anxiety and substance use disorders is essential in devising population-based suicide prevention strategies.
Authors: Matthew K Nock; Guilherme Borges; Evelyn J Bromet; Jordi Alonso; Matthias Angermeyer; Annette Beautrais; Ronny Bruffaerts; Wai Tat Chiu; Giovanni de Girolamo; Semyon Gluzman; Ron de Graaf; Oye Gureje; Josep Maria Haro; Yueqin Huang; Elie Karam; Ronald C Kessler; Jean Pierre Lepine; Daphna Levinson; Maria Elena Medina-Mora; Yutaka Ono; José Posada-Villa; David Williams Journal: Br J Psychiatry Date: 2008-02 Impact factor: 9.319
Authors: Alize J Ferrari; Rosana E Norman; Greg Freedman; Amanda J Baxter; Jane E Pirkis; Meredith G Harris; Andrew Page; Emily Carnahan; Louisa Degenhardt; Theo Vos; Harvey A Whiteford Journal: PLoS One Date: 2014-04-02 Impact factor: 3.240