Risk Factors for Suicide Attempts and Suicidal Ideation

A research team calculated that 90 percent of new onset suicide attempts and 71 percent of new onset suicidal ideation in Belgium could be prevented by effectively addressing (that is, eliminating the effects of) five risk factor groups: parental psychopathology, childhood adversities, trauma, chronic physical conditions, and mental disorders.  The authors concluded that although “new onset suicidal thoughts and behaviors is mostly attributable to proximal risk factors such as mental disorders…distal risk factors like childhood adversities or trauma also play a considerable role in the new onset of suicidal thoughts and behaviors.” Distal risk factors may have an especially important influence on new onset suicide attempts among people with ongoing ideation.

The study examined the proportion of new onset suicide attempts and ideation that could be attributed to each of the five risk factor groups when taking into account the effect of the other risk factor groups that are also associated with suicide attempts and ideation. The highest percentages of new onset suicide attempts (49 percent) and new onset suicidal ideation (39 percent) were attributed to mental disorders. Chronic physical conditions accounted for 18.7 percent of new onset suicide attempts and 20.4 percent of new onset ideation. Childhood adversities (i.e. physical or sexual abuse, neglect, parental death, physical illness, and financial problems before the age of 18) accounted for 21 percent of new onset suicide attempts and 10.9 percent of new onset ideation. Parental psychopathology accounted for 14 percent of ideation but was not found to contribute to attempts after the influence of the other risk factors was taken into consideration. Trauma occurring outside the family (i.e. violence, sexual violence, disasters, accidents, combat, war, refugee experiences, and death or trauma to a loved one) was found to account for 14 percent of attempts and 10 percent of ideation.

The category of mental disorders, on its own, was not associated with suicide attempts by ideators. The authors also found that, taken together, only 37 percent of suicide attempts among people with suicidal ideation could be attributed to the presence of the four other risk factor groups. The authors concluded that this data made it “clear that most risk factors for a suicide attempt among ideators are still unknown.”

The authors also reported that because their survey methodology had to exclude certain mental disorders (psychosis and dementia) and because research shows that a high percentage of people forget or suppress childhood adversities, it is likely that the influence of these two risk factor groups were underestimated.

Bruffaerts, R., Kessler, R. C., Demyttenaere, K., Bonnewyn, A., & Nock, M. K. (2015). Examination of the population attributable risk of different risk factor domains for suicidal thoughts and behaviors. Journal of Affective Disorders, 187, 66–72.