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Prevalence of suicide ideation and suicide attempts in nine countries

Published online by Cambridge University Press:  01 January 1999

M. M. WEISSMAN
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
R. C. BLAND
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
G. J. CANINO
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
S. GREENWALD
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
H.-G. HWU
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
P. R. JOYCE
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
E. G. KARAM
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
C.-K. LEE
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
J. LELLOUCH
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
J.-P. LEPINE
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
S. C. NEWMAN
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
M. RUBIO-STIPEC
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
J. E. WELLS
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
P. J. WICKRAMARATNE
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
H.-U. WITTCHEN
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany
E.-K. YEH
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons of Columbia University and Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico; Department of Psychiatry, National Taiwan University Hospital and Department of Psychiatry, Taipei Medical College, Taipei, Taiwan; Department of Psychological Medicine and Department of Public Health and General Practice, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry and Psychology, St. George Hospital, American University of Beirut, Lebanese University, St. Joseph University and Institute for Development of Research and Applied Care, Lebanon; Keyo Psychiatric Institute, Kyongii-Do, Republic of Korea; INSERM U 169, Villejuif and Hôpital Fernand Widal, Paris, France; and Max Planck Institute for Psychiatry, Clinical Institute, Munich, Germany

Abstract

Background. There are few cross-national comparisons of the rates of suicide ideation and attempts across diverse countries. Nine independently conducted epidemiological surveys using similar diagnostic assessment and criteria provided an opportunity to obtain that data.

Methods. Suicide ideation and attempts were assessed on the Diagnostic Interview Schedule in over 40000 subjects drawn from the United States, Canada, Puerto Rico, France, West Germany, Lebanon, Taiwan, Korea and New Zealand.

Results. The lifetime prevalence rates/100 for suicide ideation ranged from 2·09 (Beirut) to 18·51 (Christchurch, New Zealand). Lifetime prevalence rates/100 for suicide attempts ranged from 0·72 (Beirut) to 5·93 (Puerto Rico). Females as compared to males had only marginally higher rates of suicidal ideation in most countries, reaching a two-fold increase in Taiwan. Females as compared to males had more consistently higher rates for suicide attempts, reaching a two- to three-fold increase in most countries. Suicide ideation and attempts in most countries were associated with being currently divorced/separated as compared to currently married.

Conclusions. While the rates of suicide ideation varied widely by country, the rates of suicide attempts were more consistent across most countries. The variations were only partly explained by variation in rates of psychiatric disorders, divorce or separation among countries and are probably due to cultural features that we do not, as yet, understand.

Type
Research Article
Copyright
© 1999 Cambridge University Press

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