Samples Hillary, Cruz Naomi, Corr Allison, Akkas Farzana
Center for Pharmacoepidemiology and Treatment Science, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey (Samples); Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey (Samples, Cruz); Pew Charitable Trusts, Washington, D.C. (Corr, Akkas).
Psychiatr Serv. 2025 Feb 1;76(2):110-119. doi: 10.1176/appi.ps.20230466. Epub 2024 Sep 23.
Recent trends in U.S. suicide rates underscore a need for research on the risk for suicidality. The authors aimed to estimate national trends in suicidal ideation, suicide attempts, and health care utilization by using data from the 2015-2019 National Survey on Drug Use and Health.
Logistic regression was used to estimate the adjusted odds of past-year suicidal ideation and, among individuals with ideation, past-year suicide attempts, with separate interaction models estimating time trends by sex, age, and race-ethnicity. Time trends were further examined with logistic regression to estimate annual prevalence, overall and by sociodemographic, behavioral, and clinical characteristics. Logistic regression was used to estimate past-year general and mental health care utilization among adults with suicidal ideation. Analyses were survey weighted.
Overall, 4.3% (N=13,195) of adults (N=214,505) reported suicidal ideation, and 13.0% (N=2,009) of those with ideation reported suicide attempts. Increases in prevalence of suicidal ideation, from 4.0% in 2015 to 4.9% in 2019, were significantly higher for young adults ages 18-25 years (p=0.001) than for older adults. Decreases in prevalence of suicide attempts among White adults (by 32.9%) were offset by increases among adults reporting Black (by 48.0%) and multiracial or other (by 82.3%) race-ethnicity. Less than half of adults with suicidal ideation (47.8%) received past-year mental health care, with significantly lower receipt for nearly all minoritized racial-ethnic groups, compared with White adults.
Widening racial-ethnic disparities in suicide attempts and lower mental health care utilization for minoritized groups underscore the importance of developing and implementing equity-focused, evidence-based suicide prevention strategies across health care settings.
美国自杀率的近期趋势凸显了对自杀风险研究的必要性。作者旨在利用2015 - 2019年全国药物使用和健康调查的数据，估计自杀意念、自杀未遂及医疗保健利用情况的全国趋势。
采用逻辑回归估计过去一年自杀意念的调整后比值比，对于有自杀意念的个体，估计过去一年自杀未遂的调整后比值比，并通过单独的交互模型按性别、年龄和种族 - 族裔估计时间趋势。用逻辑回归进一步研究时间趋势，以估计总体及按社会人口学、行为和临床特征划分的年度患病率。采用逻辑回归估计过去一年有自杀意念的成年人的一般医疗和心理健康保健利用率。分析采用调查加权。
总体而言，成年人（N = 214,505）中有4.3%（N = 13,195）报告有自杀意念，有自杀意念者中有13.0%（N = 2,009）报告有自杀未遂。18 - 25岁的年轻人自杀意念患病率从2015年的4.0%上升到2019年的4.9%，显著高于老年人（p = 0.001）。白人成年人自杀未遂患病率下降（32.9%）被报告为黑人（48.0%）、多种族或其他种族 - 族裔（82.3%）的成年人患病率上升所抵消。有自杀意念的成年人中不到一半（47.8%）在过去一年接受了心理健康保健，与白人成年人相比，几乎所有少数族裔群体的接受率都显著较低。
自杀未遂方面种族 - 族裔差异不断扩大，以及少数族裔群体心理健康保健利用率较低，凸显了在医疗保健环境中制定和实施以公平为重点、基于证据的自杀预防策略的重要性。
