Academic journal article The Israel Journal of Psychiatry and Related Sciences

Suicide Ideation, Planning and Attempts: Results from the Israel National Health Survey

Academic journal article The Israel Journal of Psychiatry and Related Sciences

Suicide Ideation, Planning and Attempts: Results from the Israel National Health Survey

Article excerpt

Abstract: Objectives: To establish the lifetime prevalence rates of suicide ideations, plans and attempts, and to identify the conditional risks of suicide attempts following the prior onset of suicide ideation or planning. Method: A representative sample extracted from the National Population Register of non-institutionalized residents, aged 21 or older, were interviewed at home between May 2003 and April 2004 using the Composite International Diagnostic Interview which included questions on suicide ideations, plans and attempts The final sample included 4,859 respondents. Results: About 5.5% of the adults reported that they have thought of suicide, and 1.4 % that they have attempted to commit suicide during their lifetime. The year following the onset of ideation constitutes the year of highest risk for suicide attempt. Conclusion: The risk of suicide attempt is highest among individuals with mental health disorders, while the transition from suicide ideation to suicide attempt among them is more likely to be planned. The youngest age group has the highest odds of suicide attempts and the highest odds of impulsive suicide attempts.

Introduction

Suicidal behavior might be regarded as a process of varied length that usually stretches over many years, from suicide ideation (thoughts about the worthlessness of life and death wishes) to concrete planning ending in actual suicide attempts (1,2). The study of such a process in the general population is important, for the prediction of potentially preventable deaths, and for the relief and monitoring of the high distress level expressed by this behavior.

Information on suicide attempts in the Israeli general population was until now based on emergency department (ED) admissions (3, 4). Community surveys on suicidal behaviors were until now limited to samples of school children and youth (5) and to a limited study on suicidal ideation among Jewish-Israeli adults (6).

The Israel National Health Survey (INHS), designed to collect data on a wide variety of mental health and related topics, provided the first opportunity to study the prevalence rates and the associated factors of the three components of suicidal behaviors in the general population. This paper presents the lifetime prevalence rates of suicide ideations, plans and attempts, and the conditional risks of suicide attempts given the prior onset of suicide ideation or plan. In addition, we present the risk of suicide in the context of anxiety, mood or substance disorders and of other socio-demographic variables. The effect of DSM-IV disorders and other risk factors is examined also on the odds of the transition from ideation to planning, and the transition from ideation to attempt in the presence or absence of a plan.

Methods

The Israeli survey is part of the World Mental Health Survey (WMH) (7) and followed the procedures established by the project coordinators (7). The sample was extracted from the National Population Register (NPR), and comprised non-institutionalized de jure residents aged 21 and over. It was designed to reflect a distribution of respondents combining gender, age and population groups (i.e., Arab-Israelis, immigrants from the former U.S.S.R. since 1990, Jewish-Israelis and others not included in the first two groups). The interviewed sample was weighted back to the total population to compensate for unequal selection probabilities resulting from disproportionate stratification, clustering effects and non-response. The weights were adjusted to make weighted sample totals conform to known population totals taken from reliable Central Bureau of Statistics (CBS) sources. Face-to-face interviews at the respondents' home were conducted from May 2003 to April 2004 in Arabic, Hebrew or Russian. The survey was administered using laptop Computer-Assisted Personal Interview (CAPI) methods by professional survey interviewers trained and supervised by the CBS. A letter, signed by the Government Statistician explaining the purpose of the survey and the rights of respondents, was sent to each potential respondent a few days prior to the first contact attempt. …

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