Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-19T01:41:38.042Z Has data issue: false hasContentIssue false
  • English
  • Français

Suicidality, ethnicity and immigration in the USA

Published online by Cambridge University Press:  26 October 2011

G. Borges ,
R. Orozco ,
C. Rafful ,
E. Miller  and
J. Breslau
G. Borges*
Affiliation:
National Institute of Psychiatry, Mexico City, Mexico
R. Orozco
Affiliation:
National Institute of Psychiatry, Mexico City, Mexico
C. Rafful
Affiliation:
National Institute of Psychiatry, Mexico City, Mexico
E. Miller
Affiliation:
University of Pittsburgh, Pittsburgh, PA, USA
J. Breslau
Affiliation:
RAND Corporation, Pittsburgh, PA, USA
*
*Address for correspondence: Dr G. Borges, Departamento de Modelos de Intervención, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría, Calzada México Xochimilco No. 101, Col. San Lorenzo Huipulco, México D.F., C.P. 14370, Mexico. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Suicide is the 11th leading cause of death in the USA. Suicide rates vary across ethnic groups. Whether suicide behavior differs by ethnic groups in the USA in the same way as observed for suicide death is a matter of current discussion. The aim of this report was to compare the lifetime prevalence of suicide ideation and attempt among four main ethnic groups (Asians, Blacks, Hispanics, and Whites) in the USA.

Method

Suicide ideation and attempts were assessed using the World Mental Health version of the Composite International Diagnostic Interview (WMH-CIDI). Discrete time survival analysis was used to examine risk for lifetime suicidality by ethnicity and immigration among 15 180 participants in the Collaborative Psychiatric Epidemiological Surveys (CPES), a group of cross-sectional surveys.

Results

Suicide ideation was most common among Non-Hispanic Whites (16.10%), least common among Asians (9.02%) and intermediate among Hispanics (11.35%) and Non-Hispanic Blacks (11.82%). Suicide attempts were equally common among Non-Hispanic Whites (4.69%), Hispanics (5.11%) and Non-Hispanic Blacks (4.15%) and less common among Asians (2.55%). These differences in the crude prevalence rates of suicide ideation decreased but persisted after control for psychiatric disorders, but disappeared for suicide attempt. Within ethnic groups, risk for suicidality was low among immigrants prior to migration compared to the US born, but equalized over time after migration.

Conclusions

Ethnic differences in suicidal behaviors are explained partly by differences in psychiatric disorders and low risk prior to arrival in the USA. These differences are likely to decrease as the US-born proportion of Hispanics and Asians increases.

Keywords

Attemptepidemiologyethnicityracesuicide
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 6 , June 2012 , pp. 1175 - 1184
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alegria, M, Mulvaney-Day, N, Torres, M, Polo, A, Cao, Z, Canino, G (2007). Prevalence of psychiatric disorders across Latino subgroups in the United States. American Journal of Public Health 97, 68–75.CrossRefGoogle ScholarPubMed
Baca-Garcia, E, Perez-Rodriguez, MM, Keyes, K, Oquendo, MA, Hasin, D, Grant, BF, Blanco, C (2010). Suicidal ideation and suicide attempts in the United States: 1991–1992 and 2001–2002. Molecular Psychiatry 15, 250–259.CrossRefGoogle ScholarPubMed
Baca-Garcia, E, Perez-Rodriguez, MM, Keyes, K, Oquendo, MA, Hasin, D, Grant, BF, Blanco, C (2011). Suicidal ideation and suicide attempts among Hispanic subgroups in the United States: 1991–1992 and 2001–2002. Journal of Psychiatric Research 45, 512–518.CrossRefGoogle ScholarPubMed
Borges, G, Angst, J, Nock, MK, Ruscio, AM, Kessler, RC (2008). Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. Journal of Affective Disorders 105, 25–33.CrossRefGoogle ScholarPubMed
Borges, G, Angst, J, Nock, MK, Ruscio, AM, Walters, EE, Kessler, RC (2006). A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R). Psychological Medicine 36, 1747–1757.CrossRefGoogle ScholarPubMed
Borges, G, Breslau, J, Su, M, Miller, M, Medina-Mora, ME, Aguilar-Gaxiola, S (2009). Immigration and suicidal behavior among Mexicans and Mexican-Americans. American Journal of Public Health 99, 728–733.CrossRefGoogle ScholarPubMed
Borges, G, Nock, MK, Haro, JM, Hwang, I, Sampson, N, Alonso, J, Andrade, L, Angermeyer, M, Beautrais, AL, Bromet, E, Bruffaerts, R, Girolamo, G, Florescu, S, Gureje, O, Hu, C, Karam, EG, Kovess, V, Lee, S, Levinson, D, Medina-Mora, ME, Ormel, J, Posada-Villa, J, Sagar, R, Tomov, T, Uda, H, Williams, DR, Kessler, RC (2010). Twelve month prevalence of and risk factors for suicide attempts in the WHO World Mental Health Surveys. Journal of Clinical Psychiatry 71, 1617–1628.CrossRefGoogle Scholar
Breslau, J, Aguilar-Gaxiola, S, Borges, G, Kendler, K, Su, M, Kessler, RC (2007). Risk for psychiatric disorder among immigrants and their US-born descendants: evidence from the National Comorbidity Survey Replication. Journal of Nervous and Mental Disease 195, 189–195.CrossRefGoogle ScholarPubMed
Breslau, J, Aguilar-Gaxiola, S, Kendler, K, Su, M, Williams, D, Kessler, RC (2006). Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine 36, 57–68.CrossRefGoogle Scholar
Breslau, J, Borges, G, Hagar, Y, Tancredi, D, Gilman, S (2009). Immigration to the USA and risk for mood and anxiety disorders: variation by origin and age at immigration. Psychological Medicine 39, 1117–1127.CrossRefGoogle Scholar
Breslau, J, Chang, DF (2006). Psychiatric disorders among foreign-born and US-born Asian-Americans in a US national survey. Social Psychiatry and Psychiatric Epidemiology 41, 943–950.CrossRefGoogle Scholar
Canino, G, Roberts, RE (2001). Suicidal behavior among Latino youth. Suicide and Life-Threatening Behavior 31, 122–131.CrossRefGoogle ScholarPubMed
CDC (2009). Youth Risk Behavior Surveillance System (YRBSS). National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health. Centers for Disease Control and Prevention: Atlanta, GA (www.cdc.gov/HealthyYouth/yrbs/). Accessed 12 October 2011.Google Scholar
CDC (2011). Web-based Injury Statistics Query and Reporting System (WISQARS). National Center for Injury Prevention and Control. Centers for Disease Control and Prevention: Atlanta, GA (webappa.cdc.gov/sasweb/ncipc/mortrate10_sy.html). Accessed 11 February 2011.Google Scholar
Choi, JL, Rogers, JR, Werth, Jr. JL (2007). Suicide risk assessment with Asian American college students: a culturally informed perspective. The Counselling Psychologist 37, 186–218.CrossRefGoogle Scholar
CPES (2008). Collaborative Psychiatric Epidemiology Surveys: CPES Processing Notes (www.icpsr.umich.edu/files/CPES/CPES%20Processing%20Notes.pdf). Accessed 3 August 2011.Google Scholar
Crawford, MJ, Nur, U, McKenzie, K, Tyrer, P (2005). Suicidal ideation and suicide attempts among ethnic minority groups in England: results of a national household survey. Psychological Medicine 35, 1369–1377.CrossRefGoogle ScholarPubMed
Crosby, A, Ortega, L, Stevens, MR;Centers for Disease Control and Prevention (CDC) (2011). Suicides – United States. 1999–2007. MMWR Surveillance Summaries 14, 56–59.Google Scholar
Duldulao, AA, Takeuchi, D, Hong, S (2009). Correlates of suicidal behaviors among Asian Americans. Archives of Suicide Research 13, 277–290.CrossRefGoogle ScholarPubMed
Efron, B (1988). Logistic regression, survival analysis, and the Kaplan-Meier curve. Journal of the American Statistical Association 83, 414–425.CrossRefGoogle Scholar
Fortuna, LR, Perez, DJ, Canino, C, Sribney, W, Alegria, M (2007). Prevalence and correlates of lifetime suicidal ideation and suicide attempts among Latino subgroups in the United States. Journal of Clinical Psychiatry 68, 572–581.CrossRefGoogle ScholarPubMed
Galfalvy, H, Huang, YY, Oquendo, MA, Currier, D, Mann, JJ (2009). Increased risk of suicide attempt in mood disorders and TPH1 genotype. Journal of Affective Disorders 115, 331–338.CrossRefGoogle ScholarPubMed
Goldsmith, SK, Pellmar, TC, Kleinman, AM (2002). Reducing Suicide: A National Imperative. National Academies Press: Washington, DC.Google Scholar
Goldstein, RB, Black, DW, Nasrallah, A, Winokur, G (1991). The prediction of suicide. Sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patients with affective disorders. Archives of General Psychiatry 48, 418–422.CrossRefGoogle ScholarPubMed
Grieco, EM (2010). Race and Hispanic Origin of the Foreign-Born Population in the United States: 2007. US Department of Commerce, Economics, and Statistics Administration: Washington, DC.Google Scholar
Heeringa, S, Wagner, J, Torres, M, Duan, N, Adams, T, Berglund, P (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research 13, 221–240.CrossRefGoogle Scholar
Joe, S, Baser, R, Breeden, G, Neighbors, H, Jackson, JS (2006). Prevalence of and risk factors for lifetime suicide attempts among blacks in the United States. Journal of the American Medical Association 296, 2112–2123.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Chiu, WT, Demler, O, Heeringa, S, Hiripi, E, Jin, R, Pennell, BE, Walters, EE, Zaslavsky, A, Zheng, H (2004). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research 8, 69–92.CrossRefGoogle Scholar
Kessler, RC, Berglund, P, Borges, G, Nock, M, Wang, PS (2005). Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. Journal of the American Medical Association 293, 2487–2495.CrossRefGoogle ScholarPubMed
Kessler, RC, Borges, G, Walters, EE (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry 56, 617–626.CrossRefGoogle ScholarPubMed
Knauper, B, Cannell, CF, Schwarz, N, Bruce, ML, Kessler, RC (1999). Improving accuracy of major depression age-of-onset reports in the US National Comorbidity Survey. International Journal of Methods in Psychiatric Research 8, 39–48.CrossRefGoogle Scholar
Mann, JJ, Waternaux, C, Haas, GL, Malone, KM (1999). Toward a clinical model of suicidal behavior in psychiatric patients. American Journal of Psychiatry 156, 181–189.CrossRefGoogle Scholar
Moscicki, EK, O'Carroll, P, Rae, DS, Locke, BZ, Roy, A, Regier, DA (1988). Suicide attempts in the Epidemiologic Catchment Area Study. Yale Journal of Biology and Medicine 61, 259–268.Google ScholarPubMed
NIMH (2010). Collaborative Psychiatric Epidemiology Surveys. National Institute of Mental Health (http://www.icpsr.umich.edu/files/CPES/CPES%20Weights%20Chart.pdf). Accessed 16 March 2010.Google Scholar
Nock, MK, Borges, G, Bromet, E, Cha, CB, Kessler, RC, Lee, S (2008). Suicide and suicidal behavior. Epidemiologic Reviews 30, 133–154.CrossRefGoogle ScholarPubMed
Nock, MK, Hwang, I, Sampson, N, Kessler, RC, Angermeyer, M, Beautrais, AL, Borges, G, Bromet, E, Bruffaerts, R, de Girolamo, G, de Graaf, R, Florescu, S, Gureje, O, Haro, JM, Hu, C, Huang, Y, Karam, EG, Kawakami, N, Kovess, V, Levinson, D, Posada-Villa, J, Sagar, R, Tomov, T, Viana, MC, Williams, DR (2009). Cross-national analysis of the associations among mental disorders and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS Medicine 6, e1000123.CrossRefGoogle ScholarPubMed
Nock, MK, Prinstein, MJ (2005). Clinical features and behavioral functions of adolescent self-mutilation. Journal of Abnormal Psychology 114, 140–146.CrossRefGoogle Scholar
Oquendo, MA, Dragatsi, D, Harkavy-Friedman, J, Dervic, K, Currier, D, Burke, AK (2005). Protective factors against suicidal behavior in Latinos. Journal of Nervous and Mental Disease 193, 438–443.CrossRefGoogle ScholarPubMed
Oquendo, MA, Lizardi, D, Greenwald, S, Weissman, MM, Mann, JJ (2004). Rates of lifetime suicide attempt and rates of lifetime major depression in different ethnic groups in the United States. Acta Psychiatrica Scandinavica 110, 446–451.CrossRefGoogle ScholarPubMed
Perez-Rodriguez, MM, Baca-Garcia, E, Oquendo, MA, Blanco, C (2008). Ethnic differences in suicidal ideation and attempts. Primary Psychiatry 15, 44–53.Google ScholarPubMed
Pew Hispanic Center (2010). Hispanics of Puerto Rican Origin in the United States, 2008 (pewhispanic.org/files/factsheets/58.pdf). Accessed 12 October 2011.Google Scholar
Roberts, RE, Roberts, CR, Xing, Y (2007). Are Mexican American adolescents at greater risk of suicidal behaviors? Suicide and Life-Threatening Behavior 37, 10–21.CrossRefGoogle ScholarPubMed
Singh, GK, Hiatt, RA (2006). Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979–2003. International Journal of Epidemiology 35, 903–919.CrossRefGoogle ScholarPubMed
Smokowski, PR, David-Ferdon, C, Stroupe, N (2009). Acculturation and violence in minority adolescents: a review of the empirical literature. Journal of Primary Prevention 30, 215–263.CrossRefGoogle ScholarPubMed
SUDAAN (2005). SUDAAN Language Manual, Resease 9.0. Research Triangle Insitute: Research Triangle Park, NC.Google Scholar
Suominen, K, Isometsa, E, Suokas, J, Haukka, J, Achte, K, Lonnqvist, J (2004). Completed suicide after a suicide attempt: a 37-year follow-up study. American Journal of Psychiatry 161, 562–563.CrossRefGoogle ScholarPubMed
Takeuchi, DT, Zane, N, Hong, S, Chae, DH, Gong, F, Gee, GC, Walton, E, Sue, S, Alegria, M (2007). Immigration-related factors and mental disorders among Asian Americans. American Journal of Public Health 97, 84–90.CrossRefGoogle ScholarPubMed
OMH (2010). OMB Standards for Data on Race and Ethnicity. The Office of Minority Health, US Department of Health and Human Sciences (http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=172). Accessed 3 August 2011.Google Scholar
Turner, CF, Ku, L, Rogers, SM, Lindberg, LD, Pleck, JH, Sonenstein, FL (1998). Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science 280, 867–873.CrossRefGoogle ScholarPubMed
Willett, JB, Singer, JD (1993). Investigating onset, cessation, relapse, and recovery: why you should, and how you can, use discrete-time survival analysis to examine event occurrence. Journal of Consulting and Clinical Psychology 61, 952–964.CrossRefGoogle ScholarPubMed
Williams, DR, Haile, R, Gonzalez, HM, Neighbors, H, Baser, R, Jackson, JS (2007). The mental health of black Caribbean immigrants: results from the National Survey of American Life. American Journal of Public Health 97, 52–59.CrossRefGoogle ScholarPubMed