Prevalence of suicide ideation, plans, and attempts and related risk factors in Italy: results from the European Study on the Epidemiology of Mental Disorders--World Mental Health study.

BACKGROUND

As in other Mediterranean countries, suicide mortality rates in Italy are generally lower than they are in Northern and Central European countries and on other continents (eg, North America, Australia). Yet, no studies to date have examined the prevalence of and risk factors for suicide ideation, plans, and attempts, in the general population in Italy.

METHODS

Suicide ideation, plans, and attempts and potential risk factors were assessed in a community survey conducted with 4712 adult respondents (response rate, 71.2%). The participants had been selected from Italian municipality resident registries and made up a stratified, multistage, clustered probability sample. The project was part of the World Health Organization World Mental Health (WMH) Survey Initiative.

RESULTS

The lifetime prevalence (SE) of suicide ideation, plans, and attempts was 3.0% (0.3), 0.7% (0.1), and 0.5% (0.1), respectively. Prevalence rates of these suicide-related phenomena did not differ by Italian geographic macro-area (Northern, Central, and Southern Italy, including the islands of Sicily and Sardinia). Among ideators, the probability of ever making a plan was 24.6% (4.0) and attempt was 18.2% (4.5). The probability of making an attempt for ideators having made a suicide plan was nearly 50%. Risk factors for lifetime suicide-related phenomena were female sex, younger cohort, fewer years of education, and earlier onset age of suicide ideation. The presence of a common mental disorder, especially if comorbid, was associated with a significantly increased risk for all suicide phenomena investigated (ideation, plans, and attempts suicide). There were no substantial differences in the frequency of these phenomena among the 3 main macro-areas examined, that is, Northern, Central, and Southern Italy (including Sicily and Sardinia), which conversely show marked climate, socioeconomic, and cultural differences.

CONCLUSION

As shown in previous studies examining suicide, suicide continuum phenomena (in terms of ideation, plans, and attempt) in Italy were lower than typically observed for other European countries and did not differ for different macro-areas presenting remarkably different socioeconomic conditions. Prevalence rates of common mental disorders were equally lower in Italy than in other European countries. Although the detection of mental disorders represents an important step in suicide prevention, the correlations observed between various suicidal continuum manifestations suggest that timely recognition of suicide ideation and plans is an equally crucial factor in the implementation of effective preventive policies.