Sex- and age-related increase in prevalence rates of death wishes and suicidal ideation in the community: Results from the KORA-F3 Augsburg Study with 3154 men and women, 35 to 84 years of age

doi:10.1016/j.psychres.2008.03.011

Psychiatry Research

Volume 161, Issue 2, 30 November 2008, Pages 248-252

https://doi.org/10.1016/j.psychres.2008.03.011 Get rights and content

Abstract

Among risk factors for suicide, suicidal ideation (SID) is of paramount importance. This study sought to determine sex- and age-related SID point prevalence rates in the general population. A population-based survey of 3154 subjects, 35 to 84 years, conducted in 2004/05 in southern Germany, identified 170 subjects (5.4%; 95% CI 4.6–6.2) suffering from SID within the last 14 days. Age-adjusted short-term period prevalence in women (6.0%, 95% CI 4.9.–7.2) was higher than in men (4.0%, 95% CI 3.1–5.1). Among 10-year age groups, sex-related differences were only significant in middle-aged subjects (55–64 years). Prevalence increased significantly with age, leading to a prevalence of > 10% in the oldest age group (75–84 years). The population-based approach demonstrates a substantial proportion of subjects suffering from SID, particularly in older age groups.

Introduction

Death through suicide represents a significant global disease burden (World Health Organization, 2002). Suicides often occur unexpectedly and appear to have been unforeseeable. Among identified risk factors for suicide, engagement in death wishes and suicidal ideation (SID) are known to be of paramount importance ( Kuo et al., 2001). SID are an important step in a process of suicide, characterised by a stepwise hierarchy of actions with an underlying gradient of severity. Ideations precede planning that may result in an attempt leading to death (Kessler et al., 1999). SID is more common than suicide attempts, which are likewise more frequent than completed suicide (Bertolote et al., 2005). SID can be assessed by suicidal ideation scales (e.g. the Beck Scale for Suicidal Ideation; BSS) (Beck et al., 1979) or by single item questions focussing on death wishes (e.g. question 15 from the Symptom Checklist—90 Revised) (Derogatis, 1994).

The lifetime prevalence of SID ranges from approximately 8 to 18% across diverse countries (Kessler et al., 1999, Weissman et al., 1999, Druss and Pincus, 2000, Bernal et al., 2007), except China, where the lifetime SID prevalence, at 3.1% in urban regions, is considerably lower (Lee et al., 2007). Period prevalence rates (generally covering 12-month periods) in unselected populations are around 11% (Hintikka et al., 2001). Data on short-term period prevalence rates (covering approximating 14 days) are sparse and range between 2.6% (Goldney et al., 2001) and 6.5% (Gili-Planas et al., 2001).

Older adults are considered to be less likely to endorse SID than younger subjects (Duberstein et al., 1999, Conwell et al., 2002)—however, population-based data on SID prevalence rates as a function of age and gender are insufficient for firm conclusions. The present study was carried out to assess sex- and age-specific prevalence rates of SID in a population-based survey over the life span from 35 to 84 years of age.

Section snippets

Design and subjects

The data stem from the city of Augsburg (Bavaria, Germany) and from surrounding districts covering about 600,000 inhabitants drawn from mixed urban and rural areas whose demographic and socioeconomic characteristics roughly reflect those of the average middle European population in general.

The present analysis investigates data from the population-based KORA F3 survey conducted in 2004/05 within the framework of the ongoing KORA project (Cooperative Health Research in the Augsburg Region,

Results

Among the study population of 3154 participants, a total of 170 subjects (5.4%; 95% CI 4.6–6.2) reported some form of suicidal ideation within the prior 2 weeks. Age-adjusted SID prevalence was higher (P = 0.009) in women (6.0%, 95% CI 4.9.–7.2) than in men (4.0%, 95% CI 3.1–5.1). However, among 10-year age groups, sex-related differences were only significant (P = 0.019) in middle-aged subjects (55–64 years).

Fig. 1 illustrates graphically that SID prevalence increased with increasing age. A test

Discussion

The first major result of the present investigation is to show an overall short-term SID prevalence rate of 5.4% (95% CI 4.6–6.2) in an unselected population-based sample aged 35 to 84 years. It is not surprising that the short-term prevalence rate shown here is lower than rates for lifetime prevalence: Data from nine community-based surveys across diverse countries including over 40,000 subjects revealed a 10–18% lifetime SID prevalence (Weissman et al., 1999). Among 5877 respondents from the

Acknowledgement

The MONICA-KORA Augsburg studies are financed by the Helmholtz Zentrum München, German Research Center for Environmental Health.

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Brief reportSex- and age-related increase in prevalence rates of death wishes and suicidal ideation in the community: Results from the KORA-F3 Augsburg Study with 3154 men and women, 35 to 84 years of age

Abstract

Introduction

Section snippets

Design and subjects

Results

Discussion

Acknowledgement

Journal of Affective Disorders

Biological Psychiatry

The American Journal of Geriatric Psychiatry

Journal of Affective Disorders

Lancet

Sex- and age-specific trends in mortality from suicide and undetermined death in Germany 1991–2002

BMC Public Health

Assessment of suicidal intention: the Scale for Suicide Ideation

Journal of Consulting and Clinical Psychology

Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey

Psychological Medicine

High cholesterol, triglycerides, and body-mass index in suicide attempters

Archives of Suicide Research

SCL-90-R: Symptom Checklist-90-R—Administration, Scoring and Procedures Manual

Suicidal ideation and suicide attempts in general medical illnesses

Archives of Internal Medicine

Death wishes in the very elderly: data from a 3-year follow-up study

Acta Psychiatrica Scandinavica

Suicidal ideation, psychiatric disorder, and medical illness in a community epidemiological study

Suicide and Life-Threatening Behavior

Studying suicide from the life course perspective: implications for prevention

The British Journal of Medical Psychology

Suicidal ideation in a young adult population

Acta Psychiatrica Scandinavica

Suicidal ideation in a random community sample: attributable risk due to depression and psychosocial and traumatic events

The Australian and New Zealand Journal of Psychiatry

Brief report
Sex- and age-related increase in prevalence rates of death wishes and suicidal ideation in the community: Results from the KORA-F3 Augsburg Study with 3154 men and women, 35 to 84 years of age