Suicidal Ideation, Psychiatric Disorder, and Medical Illness in a Community Epidemiological Study

Abstract

Many epidemiological studies have analyzed suicidal ideation in clinical samples, but only a few have been performed in the general population. We present the results of a two-stage epidemiological study in the general population on the island of Formentera (Balearic Islands, Spain), which used the 28-item General Health Questionnaire (GHQ-28) in the first stage (n = 697) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) in the second (n = 242). We also recorded medical illnesses diagnosed in the subjects at the second stage. Four items on the GHQ-28 ask directly about suicidal thoughts or ideation. From the sample, 6.5% have reported suicidal ideation. Mental disorders are the most important factor associated with suicidal ideation; medical illnesses seem to play a secondary role.

The prevalence of suicidal ideation in the general population: results from the Outcome of Depression International Network (ODIN) study

“…The Spanish rate obtained by us was the one exception as it was somewhat lower than the 6.5% rate found in the study on the Spanish island of Formentera [9] while our rates for Finland are broadly in line with those of another study [6] in that country.…”

“…These figures are much lower than their nearest equivalent, suicidal plans, (1.1-15.6) reported in one study 9 . It is also noteworthy that suicidal plans were identified at all sites in that study whilst active suicide intent (SI 4), its nearest equivalent in our study, is only present in the Scandinavian and Spanish sites.…”

“…Not surprisingly much lower figures and narrower ranges are reported for recent or 2-week period prevalence, ranging from 0.8% [7] through 5.3%-8.6% [8,9] while lifetime rates are higher and vary between 2.09 and 25.4% [10,11] depending on the study and on the countries investigated.…”

The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts

“…Suicide ideation is considered by some to be the first step toward suicide (Gili-Planas et al, 2001); it is one of the strongest predictors of a future suicide attempt in adolescents and is related to risk of completed suicide (Brent et al, 1993;Lewinsohn et al, 1996;Reinherz et al, 1995). The current public health significance of suicidal thoughts and behaviors is large in the United States and globally (Murray and Lopez, 1996;United States Public Health Service, 1999).…”

Can Satisfy with Life People be Unwilling to Live?

“…Moreover, growing evidence has suggested that suicide can be conceptualized as motivated by the desire to escape from unbearable psychological pain (Durkheim, Spaulding, & Simpson, 2010).In depressed individuals, the decreased ability to experience pleasure incombination with a strong motivation to relieve pain can lead to maladaptive behavioral disinhibiting and an increased likelihood of suicide attempts. Furthermore, hopelessness, or believing future outcomes will be negative rather than positive, is one of the most prominent cognitive factors associated with depression (Abramson, Alloy, 1998;Abramson, Metalsky, & Alloy, 1989;Romens, Abramson, & Alloy, 2009;Hawton, Casanas, Haw, Saunders, 2013) and suicidality (Harris, Barraclough, 1997;Gili-Planas, Roca-Bennasar, Ferrer-Perez, Bernardo-Arroyo, 2001;Christensen,Batterham, Soubelet, & Mackinnon, 2013).Therefore, regarding suicides with help, the opinion that a person who chooses death can reflect on his situation constructively, and he is still capable to experience positive emotions, is not evidence -based. Nonetheless, supplementary research is needed to explore further the different factors contributing to unwillingness to live which is a sign of diminished psychological wellbeing.…”