Mental Disorders, Comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication

By Matthew K. Nock, I. Hwang, N. Sampson, Ronald C. Kessler. Molecular Psychiatry, 2009

1,137 citations recorded by the source corpus.

Mental disorders are among the strongest predictors of suicide attempts. However, little is known regarding which disorders that are uniquely associated with suicidal behavior because of high levels of psychiatric comorbidity. We examined the unique associations between individual disorders and subsequent suicidal behavior (suicide ideation, plans and attempts) using data from the National Comorbidity Survey Replication, a nationally representative household survey of 9282 US adults. Results revealed that approximately 80% of suicide attempters in the United States have a temporally prior mental disorder. Anxiety, mood, impulse-control and substance use disorders all significantly predict subsequent suicide attempts in bivariate analyses (odds ratios (OR)=2.7–6.7); however, these associations decrease substantially in multivariate analyses controlling for comorbidity (OR=1.5–2.3) but remain statistically significant in most cases. Disaggregation of the observed effects reveals that depression predicts suicide ideation, but not suicide plans or attempts among those with ideation. Instead, disorders characterized by severe anxiety/agitation (for example, post-traumatic stress disorder) and poor impulse control (for example, conduct disorder, substance use disorders) predict which suicide ideators who go on to make a plan or attempt. These results advance understanding of the unique associations between mental disorders and different forms of suicidal behavior. Future research must further delineate the mechanisms through which people come to think about suicide and progress from suicidal thoughts to attempts.

Subfields: Clinical Psychology, Insect Science, Social Psychology

View Paper: https://www.semanticscholar.org/paper/0ffc3af2dbc5bfe19c9e2a57b1942f36252e130c

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Clinical Psychology

In Insect Science

In Social Psychology

Citations in the corpus

Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys (2009, background): “Several recent studies have suggested that although mental disorders are strongly predictive of suicide ideation, they are less useful in predicting which people with suicide ideation go on to make suicide plans and attempts [25,26].”
Suicide Attempts Among Transgender and Gender Non-Conforming Adults (2014, background): “In this report, we present our findings, discuss their implications, and conclude by describing considerations and needs for future research.”
What Distinguishes Suicide Attempters From Suicide Ideators? A Meta‐Analysis of Potential Factors (2016, background): “For example, accumulating evidence suggests that much of the predictive power of Axis I disorders for suicide attempts is explained by the relationship of these disorders to suicide ideation, rather than to attempts (Nock et al., 2010).”
Prevalence, correlates and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A) (2013, result): “These findings are consistent with recent findings in epidemiological studies of adults, in which MDD emerged as the strongest predictor of suicidal thoughts compared with disorders characterized by anxiety, agitation, and poor behavioral control, which were the strongest predictors of a suicide att”