Prevalence and risk factors for first onset of suicidal behaviors in the Netherlands Mental Health Survey and Incidence Study-2

Background: To report lifetime prevalences of suicidal ideation, plans and attempts, as well as risk factors for first onset suicidal behaviours and for the transition from ideation to first onset plan or attempt. Methods: Data were used from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative survey among the general population aged 18-64 years (N = 6646; response rate = 65.1%). Face-to-face interviews were administered between November 2007 and July 2009. Suicidal behaviours and DSM-IV mental disorders were assessed using the Composite International Diagnostic Interview 3.0. Results: The lifetime prevalence of suicidal ideation, plan and attempt was 8.3%, 3.0% and 2.2%, respectively. Among ideators, the probability of ever making an attempt was 26.8%. 76.5% of transitions from ideation to attempt occurred within the first year after ideation onset. Risk factors for suicidal behaviours included being female, younger, less educated, having had childhood trauma and a prior mental disorder. The strongest risk factors for the transition from ideation to first onset attempt were characteristics of prior suicidal behaviours, such as an early age of ideation onset and prior plans. Limitations: Data were based on retrospective self-reports of mental disorders and suicidal behaviours. Conclusions: It is important that health professionals verify suicide plans of their patients with suicidal ideas. They should also discuss the way their patients deal with problems and the kind of help they need, because a substantial proportion of (first) attempts was not intended to kill oneself. Preventive measures are best offered within the first year after ideation onset. (c) 2012 Elsevier B.V. All rights reserved.