Global perspectives on suicidal behavior

Suicidal behaviors are a leading cause of injury and death worldwide and information about the epidemiology of such behaviors is important for policy-making and prevention efforts. We reviewed government data on suicide and suicidal behaviors and conducted a systematic review of studies on the epidemiology of suicidal behaviors published from 1997 to 2007. Our aims were to examine the prevalence, trends, and risk and protective factors of suicidal behaviors in the U.S. and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behaviors, but consistency in the age-of-onset (AOO), transition probabilities, and the presence of key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and among those who are young, unmarried, and have a psychiatric disorder. Despite an increase in the treatment of suicidal individuals over the past decade, incidence rates of suicidal behaviors have remained largely unchanged. Most epidemiological research on suicidal behaviors has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk factors and protective factors. New studies must incorporate recent methodological advances in survey methodology and clinical assessment and results should guide ongoing efforts to decrease the significant loss of life caused by suicidal behaviors.