Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys

TLDR

Suicide is a leading global cause of death, yet no data‑driven method exists to assess suicide‑attempt risk. This study analyzes WHO World Mental Health Survey data to estimate 12‑month prevalence of suicidal behaviors, identify risk factors, and develop a risk index for suicide attempts in developed and developing countries. Using a cross‑national epidemiologic survey of 108,705 adults from 21 countries, the authors assessed suicidal behaviors and risk factors across sociodemographic, familial, childhood, and DSM‑IV domains, reporting 12‑month prevalence rates of ideation, plans, and attempts. Risk factors such as female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversity, and multiple DSM‑IV disorders were identified, and a multivariate risk index achieved an AUC of 0.74–0.80, accurately predicting 12‑month suicide attempts and offering potential clinical utility.

Abstract

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.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.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).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.