Skip to main content
Top
Published in: European Archives of Psychiatry and Clinical Neuroscience 7/2014

01-10-2014 | Original Paper

Suicidality in the prospective Zurich study: prevalence, risk factors and gender

Authors: Jules Angst, Michael P. Hengartner, Jonathan Rogers, Ulrich Schnyder, Hans-Christoph Steinhausen, Vladeta Ajdacic-Gross, Wulf Rössler

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 7/2014

Login to get access

Abstract

Our prospective Zurich study (1978–2008) found that suicidal ideation had occurred in 40.5 % and suicide attempts in 6.6 % of the population by age 50. Important gender differences were found in both suicidality and its risk factors. Suicide attempts were earlier and more frequent among women than among men: 70 versus 44 % reported their first suicide attempt before 20. For women, the relative risk of suicide attempts was 1.6, but the relative risk of suicidal ideation was about equal (1.1 for women). The main risk factors for suicidal ideation in women were low social support (OR 4.0) and frequent punishment in childhood (OR 3.7), and in men, a depressive (OR 6.5) and an anxious personality (OR 4.6). The main risk factors for suicide attempts in women were a broken home (OR 10.2) and sexual abuse/violence (OR 7.9) in childhood; in men, no multivariate analyses of suicide attempt were conducted because of insufficient statistical power.
Literature
1.
go back to reference Yilmaz AT, Riecher-Rössler A (2012) Attempted suicide in immigrants from Turkey: a comparison with Swiss suicide attempters. Psychopathology 455:366–373CrossRef Yilmaz AT, Riecher-Rössler A (2012) Attempted suicide in immigrants from Turkey: a comparison with Swiss suicide attempters. Psychopathology 455:366–373CrossRef
2.
go back to reference Kessler RC, Borges G, Ellen EW (1999) Prevalence of and risk factors for lifetime suicide attempts in the national comorbidity survey. Arch Gen Psychiatry 56:617–626PubMedCrossRef Kessler RC, Borges G, Ellen EW (1999) Prevalence of and risk factors for lifetime suicide attempts in the national comorbidity survey. Arch Gen Psychiatry 56:617–626PubMedCrossRef
3.
go back to reference Weissman MM, Bland RC, Canino GJ, Greenwald S, Joyce H-G, Karam EG, Lee CK, Lellouch J, Lépine JP, Newman SC, Wittchenh U, Yeh E-K (1999) Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 29:9–17PubMedCrossRef Weissman MM, Bland RC, Canino GJ, Greenwald S, Joyce H-G, Karam EG, Lee CK, Lellouch J, Lépine JP, Newman SC, Wittchenh U, Yeh E-K (1999) Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 29:9–17PubMedCrossRef
4.
go back to reference Phillips MR, Cheng HG (2012) The changing global face of suicide. Lancet 379:2317–2319CrossRef Phillips MR, Cheng HG (2012) The changing global face of suicide. Lancet 379:2317–2319CrossRef
5.
go back to reference Epstein JA, Spirito A (2010) Gender-specific risk factors for suicidality among high school students. Arch Suicide Res 14:193–205PubMedCrossRef Epstein JA, Spirito A (2010) Gender-specific risk factors for suicidality among high school students. Arch Suicide Res 14:193–205PubMedCrossRef
6.
go back to reference Steinhausen H-C, Boesiger R, Winkler Metzke C (2006) Stability, correlates, and outcome of adolescent suicidal risk. J Child Psychol Psychiatry 47:713–722PubMedCrossRef Steinhausen H-C, Boesiger R, Winkler Metzke C (2006) Stability, correlates, and outcome of adolescent suicidal risk. J Child Psychol Psychiatry 47:713–722PubMedCrossRef
7.
go back to reference Steinhausen H-C, Metzke CW (2004) The impact of suicidal ideation in preadolescence, adolescence, and young adulthood on psychosocial functioning and psychopathology in young adulthood. Acta Psychiatr Scand 110:438–445PubMedCrossRef Steinhausen H-C, Metzke CW (2004) The impact of suicidal ideation in preadolescence, adolescence, and young adulthood on psychosocial functioning and psychopathology in young adulthood. Acta Psychiatr Scand 110:438–445PubMedCrossRef
8.
go back to reference Spijker J, de Graaf R, Ten Have M, Nolen WA, Speckens A (2010) Predictors of suicidality in depressive spectrum disorders in the general population: results of the Netherlands Mental Health Survey and Incidence Study. Soc Psychiatry Psychiatr Epidemiol 45:513–521PubMedCrossRef Spijker J, de Graaf R, Ten Have M, Nolen WA, Speckens A (2010) Predictors of suicidality in depressive spectrum disorders in the general population: results of the Netherlands Mental Health Survey and Incidence Study. Soc Psychiatry Psychiatr Epidemiol 45:513–521PubMedCrossRef
9.
go back to reference Ten Have M, van Dorsselaer S, de Graaf R (2013) Prevalence and risk factors for first onset of suicidal behaviors in the Netherlands Mental Health Survey and Incidence Study-2. J Affect Disord 147:205–211PubMedCrossRef Ten Have M, van Dorsselaer S, de Graaf R (2013) Prevalence and risk factors for first onset of suicidal behaviors in the Netherlands Mental Health Survey and Incidence Study-2. J Affect Disord 147:205–211PubMedCrossRef
10.
go back to reference Derogatis LR (1983) SCL-90-R. Administration, scoring & procedures manual-II for the R(evised) version and other instruments of the psychopathology rating scale series. 2nd edn. Clinical Psychometric Research, Towson Derogatis LR (1983) SCL-90-R. Administration, scoring & procedures manual-II for the R(evised) version and other instruments of the psychopathology rating scale series. 2nd edn. Clinical Psychometric Research, Towson
12.
go back to reference Dunn G, Pickles A, Tansella M, Vazquez-Barquero J-L (1999) Two-phase epidemiological surveys in psychiatry. Br J Psychiatry 174:95–100PubMedCrossRef Dunn G, Pickles A, Tansella M, Vazquez-Barquero J-L (1999) Two-phase epidemiological surveys in psychiatry. Br J Psychiatry 174:95–100PubMedCrossRef
13.
go back to reference Eich D, Ajdacic-Gross V, Condrau M, Huber H, Gamma A, Angst J, Rössler W (2003) The Zurich study: participation patterns and symptom checklist 90-R scores in six interviews, 1979–99. Acta Psychiatr Scand 108:S11–S14CrossRef Eich D, Ajdacic-Gross V, Condrau M, Huber H, Gamma A, Angst J, Rössler W (2003) The Zurich study: participation patterns and symptom checklist 90-R scores in six interviews, 1979–99. Acta Psychiatr Scand 108:S11–S14CrossRef
14.
go back to reference Angst J, Dobler-Mikola A, Binder J (1984) The Zurich study—a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. I. Problem, methodology. Eur Arch Psychiatr Neurol Sci 234:13–20CrossRef Angst J, Dobler-Mikola A, Binder J (1984) The Zurich study—a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. I. Problem, methodology. Eur Arch Psychiatr Neurol Sci 234:13–20CrossRef
15.
go back to reference Angst J, Gamma A, Neuenschwander M, Ajdacic-Gross V, Eich D, Rössler W, Merikangas KR (2005) Prevalence of mental disorders in the Zurich cohort study: a twenty year prospective study. Epidemiol Psichiatr Soc 14:68–76PubMedCrossRef Angst J, Gamma A, Neuenschwander M, Ajdacic-Gross V, Eich D, Rössler W, Merikangas KR (2005) Prevalence of mental disorders in the Zurich cohort study: a twenty year prospective study. Epidemiol Psichiatr Soc 14:68–76PubMedCrossRef
16.
go back to reference Depue RA (1987) General behavior inventory (manual). Assessment manual. University of Minnesota, Minneapolis Depue RA (1987) General behavior inventory (manual). Assessment manual. University of Minnesota, Minneapolis
17.
go back to reference Angst J, Gamma A, Rössler W, Ajdacic-Gross V, Klein DN (2011) Childhood adversity and chronicity of mood disorders. Eur Arch Psychiatry Clin Neurosci 261:21–27PubMedCrossRef Angst J, Gamma A, Rössler W, Ajdacic-Gross V, Klein DN (2011) Childhood adversity and chronicity of mood disorders. Eur Arch Psychiatry Clin Neurosci 261:21–27PubMedCrossRef
19.
go back to reference Hobfoll SE, Walfisch S (1984) Coping with a threat to life: a longitudinal study of self-concept, social support, and psychological distress. Am J Community Psychol 12:87–100PubMedCrossRef Hobfoll SE, Walfisch S (1984) Coping with a threat to life: a longitudinal study of self-concept, social support, and psychological distress. Am J Community Psychol 12:87–100PubMedCrossRef
20.
go back to reference Hobfoll SE, Walfisch S (1984) Coping with a threat to life: a longitudinal study of self-concept, social support, and psychological distress. Am J Community Psychol 12:87–100PubMedCrossRef Hobfoll SE, Walfisch S (1984) Coping with a threat to life: a longitudinal study of self-concept, social support, and psychological distress. Am J Community Psychol 12:87–100PubMedCrossRef
21.
go back to reference Fahrenberg J, Hampel R, Selg H (1985) Die revidierte Form des Freiburger Persönlichkeitsinventars FPI-R. Diagnostica 31:1–21 Fahrenberg J, Hampel R, Selg H (1985) Die revidierte Form des Freiburger Persönlichkeitsinventars FPI-R. Diagnostica 31:1–21
22.
go back to reference Bursztein C, Apter A (2009) Adolescent suicide. Curr Opin Psyciatry 22:1–6CrossRef Bursztein C, Apter A (2009) Adolescent suicide. Curr Opin Psyciatry 22:1–6CrossRef
23.
go back to reference Muheim F, Eichhorn M, Berger P, Czernin S, Stoppe G, Keck M, Riecher-Rössler A (2013) Suicide attempts in the county of Basel: results from the WHO/EURO Multicentre Study on Suicidal Behaviour. Swiss Med Wkly 143:w13759. doi:10.4414/smw.2013.13759 Muheim F, Eichhorn M, Berger P, Czernin S, Stoppe G, Keck M, Riecher-Rössler A (2013) Suicide attempts in the county of Basel: results from the WHO/EURO Multicentre Study on Suicidal Behaviour. Swiss Med Wkly 143:w13759. doi:10.​4414/​smw.​2013.​13759
24.
go back to reference Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, Kessler RC (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry 70:300–310PubMedCrossRef Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, Kessler RC (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry 70:300–310PubMedCrossRef
25.
go back to reference Consoli A, Peyre H, Speranza M, Hassler C, Falissard B, Touchette E, Cohen D, Moro MR, Révah-Lévy A (2013) Suicidal behaviors in depressed adolescents: role of perceived relationships in the family. Child Adolesc Psychiatry Ment Health 7:8PubMedCrossRefPubMedCentral Consoli A, Peyre H, Speranza M, Hassler C, Falissard B, Touchette E, Cohen D, Moro MR, Révah-Lévy A (2013) Suicidal behaviors in depressed adolescents: role of perceived relationships in the family. Child Adolesc Psychiatry Ment Health 7:8PubMedCrossRefPubMedCentral
26.
go back to reference Pitzer M, Esser G, Schmidt MH, Laucht M (2009) Temperamental predictors of externalizing problems among boys and girls: a longitudinal study in a high-risk sample from ages 3 months to 15 years. Eur Arch Psychiatry Clin Neurosci 259:445–458PubMedCrossRef Pitzer M, Esser G, Schmidt MH, Laucht M (2009) Temperamental predictors of externalizing problems among boys and girls: a longitudinal study in a high-risk sample from ages 3 months to 15 years. Eur Arch Psychiatry Clin Neurosci 259:445–458PubMedCrossRef
27.
go back to reference Fairweather-Schmidt AK, Anstey KJ, Salim A, Rodgers B (2010) Baseline factors predictive of serious suicidality at follow-up: findings focussing on age and gender from a community-based study. BMC Psychiatry 10:41PubMedCrossRefPubMedCentral Fairweather-Schmidt AK, Anstey KJ, Salim A, Rodgers B (2010) Baseline factors predictive of serious suicidality at follow-up: findings focussing on age and gender from a community-based study. BMC Psychiatry 10:41PubMedCrossRefPubMedCentral
28.
go back to reference Devries KM, Seguin M (2013) Violence against women and suicidality: does violence cause suicidal behaviour? In: García-Moreno C, Riecher-Rössler A (eds) Violence against women and mental health. Key issues ment health., vol 178. Karger, Basel, pp 148–158. doi:10.1159/000342029 Devries KM, Seguin M (2013) Violence against women and suicidality: does violence cause suicidal behaviour? In: García-Moreno C, Riecher-Rössler A (eds) Violence against women and mental health. Key issues ment health., vol 178. Karger, Basel, pp 148–158. doi:10.​1159/​000342029
29.
go back to reference Brezo J, Paris J, Vitaro F, Hébert M, Tremblay RE, Turecki G (2008) Predicting suicide attempts in young adults with histories of childhood abuse. Br J Psychiatry 193:134–139PubMedCrossRef Brezo J, Paris J, Vitaro F, Hébert M, Tremblay RE, Turecki G (2008) Predicting suicide attempts in young adults with histories of childhood abuse. Br J Psychiatry 193:134–139PubMedCrossRef
30.
go back to reference Mullen PE, Martin JL, Anderson JC, Romans SE, Herbison GP (1996) The long-term impact of the physical, emotional, and sexual abuse of children: a community study. Child Abuse Negl 20:7–21PubMedCrossRef Mullen PE, Martin JL, Anderson JC, Romans SE, Herbison GP (1996) The long-term impact of the physical, emotional, and sexual abuse of children: a community study. Child Abuse Negl 20:7–21PubMedCrossRef
31.
go back to reference Santa Mina EE, Gallop RM (1998) Childhood sexual and physical abuse and adult self-harm and suicidal behaviour: a literature review. Can J Psychiatry 43:793–800PubMed Santa Mina EE, Gallop RM (1998) Childhood sexual and physical abuse and adult self-harm and suicidal behaviour: a literature review. Can J Psychiatry 43:793–800PubMed
32.
go back to reference Leverich GS, Altshuler LL, Frye MA, Suppes T, Keck PE, McElroy SL, Denicoff KD, Obrocea G, Nolen WA, Kupka R, Walden J, Grunze H, Perez S, Luckenbaugh DA, Post RM (2003) Factors associated with suicide attempts in 648 patients with bipolar disorder in the Stanley Foundation Bipolar Network. J Clin Psychiatry 64:506–515PubMedCrossRef Leverich GS, Altshuler LL, Frye MA, Suppes T, Keck PE, McElroy SL, Denicoff KD, Obrocea G, Nolen WA, Kupka R, Walden J, Grunze H, Perez S, Luckenbaugh DA, Post RM (2003) Factors associated with suicide attempts in 648 patients with bipolar disorder in the Stanley Foundation Bipolar Network. J Clin Psychiatry 64:506–515PubMedCrossRef
33.
go back to reference Baethge C, Tondo L, Lepri B, Baldessarini RJ (2009) Coffee and cigarette use: association with suicidal acts in 352 Sardinian bipolar disorder patients. Bipolar Disord 11:494–503PubMedCrossRef Baethge C, Tondo L, Lepri B, Baldessarini RJ (2009) Coffee and cigarette use: association with suicidal acts in 352 Sardinian bipolar disorder patients. Bipolar Disord 11:494–503PubMedCrossRef
34.
go back to reference Azorin JM, Kaladjian A, Adida M, Hantouche E, Hameg A, Lancrenon S, Akiskal HS (2009) Risk factors associated with lifetime suicide attempts in bipolar I patients: findings from a French National Cohort. Compr Psychiatry 50:115–120PubMedCrossRef Azorin JM, Kaladjian A, Adida M, Hantouche E, Hameg A, Lancrenon S, Akiskal HS (2009) Risk factors associated with lifetime suicide attempts in bipolar I patients: findings from a French National Cohort. Compr Psychiatry 50:115–120PubMedCrossRef
35.
go back to reference Roy A, Janal M (2006) Gender in suicide attempt rates and childhood sexual abuse rates: is there an interaction? Suicide Life Threat Behav 36:329–335PubMedCrossRef Roy A, Janal M (2006) Gender in suicide attempt rates and childhood sexual abuse rates: is there an interaction? Suicide Life Threat Behav 36:329–335PubMedCrossRef
36.
go back to reference Kendler KS, Bulik CM, Silberg J, Hettema JM, Myers J, Prescott CA (2000) Childhood sexual abuse and adult psychiatric and substance use disorders in women. Arch Gen Psychiatry 57:953–959PubMedCrossRef Kendler KS, Bulik CM, Silberg J, Hettema JM, Myers J, Prescott CA (2000) Childhood sexual abuse and adult psychiatric and substance use disorders in women. Arch Gen Psychiatry 57:953–959PubMedCrossRef
37.
go back to reference Hahm HC, Lee Y, Ozonoff A, Van Wert MJ (2010) The impact of multiple types of child maltreatment on subsequent risk behaviors among women during the transition from adolescence to young adulthood. J Youth Adolesc 39:528–540PubMedCrossRefPubMedCentral Hahm HC, Lee Y, Ozonoff A, Van Wert MJ (2010) The impact of multiple types of child maltreatment on subsequent risk behaviors among women during the transition from adolescence to young adulthood. J Youth Adolesc 39:528–540PubMedCrossRefPubMedCentral
38.
go back to reference Bebbington PE, Cooper C, Minot S, Brugha TS, Jenkins R, Meltzer H, Dennis M (2009) Suicide attempts, gender, and sexual abuse: data from the 2000 British Psychiatric Morbidity Survey. Am J Psychiatry 166:1135–1140PubMedCrossRef Bebbington PE, Cooper C, Minot S, Brugha TS, Jenkins R, Meltzer H, Dennis M (2009) Suicide attempts, gender, and sexual abuse: data from the 2000 British Psychiatric Morbidity Survey. Am J Psychiatry 166:1135–1140PubMedCrossRef
39.
40.
go back to reference Afifi TO, Boman J, Fleisher W, Sareen J (2009) The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample. Child Abuse Negl 33:139–147PubMedCrossRef Afifi TO, Boman J, Fleisher W, Sareen J (2009) The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample. Child Abuse Negl 33:139–147PubMedCrossRef
41.
go back to reference Mittendorfer-Rutz E, Rasmussen F, Lange T (2012) A life-course study on effects of parental markers of morbidity and mortality on offspring’s suicide attempt. PLoS ONE 7:e51585PubMedCrossRefPubMedCentral Mittendorfer-Rutz E, Rasmussen F, Lange T (2012) A life-course study on effects of parental markers of morbidity and mortality on offspring’s suicide attempt. PLoS ONE 7:e51585PubMedCrossRefPubMedCentral
42.
go back to reference Cohen LJ, Foster M, Nesci C, Tanis T, Halmi W, Galynker I (2013) How do different types of childhood maltreatment relate to adult personality pathology? J Nerv Ment Dis 201:234–243PubMedCrossRef Cohen LJ, Foster M, Nesci C, Tanis T, Halmi W, Galynker I (2013) How do different types of childhood maltreatment relate to adult personality pathology? J Nerv Ment Dis 201:234–243PubMedCrossRef
43.
go back to reference Grilo CM, Masheb RM (2002) Childhood maltreatment and personality disorders in adult patients with binge eating disorder. Acta Psychiatr Scand 106:183–188PubMedCrossRef Grilo CM, Masheb RM (2002) Childhood maltreatment and personality disorders in adult patients with binge eating disorder. Acta Psychiatr Scand 106:183–188PubMedCrossRef
44.
go back to reference Hengartner MP, Ajdacic-Gross V, Rodgers S, Müller M, Rössler W (2013) Childhood adversity in association with personality disorder dimensions: new findings in an old debate. Eur Psychiatry 28:476–482PubMedCrossRef Hengartner MP, Ajdacic-Gross V, Rodgers S, Müller M, Rössler W (2013) Childhood adversity in association with personality disorder dimensions: new findings in an old debate. Eur Psychiatry 28:476–482PubMedCrossRef
45.
go back to reference Johnston AK, Pirkis JE, Burgess PM (2009) Suicidal thoughts and behaviours among Australian adults: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 43:635–643PubMedCrossRef Johnston AK, Pirkis JE, Burgess PM (2009) Suicidal thoughts and behaviours among Australian adults: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 43:635–643PubMedCrossRef
46.
go back to reference Althaus D, Hegerl U (2004) Ursachen, Diagnose und Therapie von Suizidalität. Nervenarzt 75:1123–1135PubMedCrossRef Althaus D, Hegerl U (2004) Ursachen, Diagnose und Therapie von Suizidalität. Nervenarzt 75:1123–1135PubMedCrossRef
Metadata
Title
Suicidality in the prospective Zurich study: prevalence, risk factors and gender
Authors
Jules Angst
Michael P. Hengartner
Jonathan Rogers
Ulrich Schnyder
Hans-Christoph Steinhausen
Vladeta Ajdacic-Gross
Wulf Rössler
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 7/2014
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-014-0500-1

Other articles of this Issue 7/2014

European Archives of Psychiatry and Clinical Neuroscience 7/2014 Go to the issue