Risk factors for suicide in blacks and whites: an analysis of data from the 1993 National Mortality Followback Survey.

OBJECTIVE Data on risk factors for suicide in blacks in the United States are needed, given the dramatic increase in the black suicide rate from 1980 to 1997. The 1993 National Mortality Followback Survey represented an unprecedented opportunity to identify risk factors for suicide in blacks and to determine whether race differences (black versus white) in risk factors exist. METHOD Multiple logistic regression analyses were used to compare cases of suicide (150 suicides in blacks and 1,279 suicides in whites) with cases of accidental deaths (737 cases in blacks and 3,458 cases in whites). Predictors of interest were 18 items tapping four domains: antisocial behavior, substance use/abuse, depressive symptoms, and psychotic symptoms. RESULTS Four items distinguished suicides from accidental deaths in both black and whites: death ideation, suicidal ideation, bizarre behavior, and making violent threats. Items in two of the four domains discriminated risk for suicide in whites more strongly than in blacks: reports of community complaints and problem drinking. No variable conferred greater risk for suicide in blacks than in whites. CONCLUSIONS The current study underscores the need for examination of race differences in risk factors for suicide. It is also essential to examine variables that were unavailable in the National Mortality Followback Survey data set, particularly racism, perceived discrimination, and feelings of alienation from the dominant culture.

[1]  S. Sharp,et al.  Race Differences in Strains Associated with Suicidal Behavior among Adolescents , 2002 .

[2]  Michael Witt,et al.  SUDAAN User's Manual, Release 9.0 , 2002 .

[3]  S. Garlow.  Age, gender, and ethnicity differences in patterns of cocaine and ethanol use preceding suicide. , 2002, The American journal of psychiatry.

[4]  S. Greenwald,et al.  Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. , 2001, Journal of the American Academy of Child and Adolescent Psychiatry.

[5]  A. Beautrais.  Suicides and serious suicide attempts: two populations or one? , 2001, Psychological Medicine.

[6]  M. Resnick,et al.  Adolescent suicide attempts: risks and protectors. , 2001, Pediatrics.

[7]  L. Morrison,et al.  Racial differences in self-disclosure of suicidal ideation and reasons for living: implications for training. , 2000, Cultural diversity & ethnic minority psychology.

[8]  M. Foster.  Positive and Negative Responses to Personal Discrimination: Does Coping Make a Difference? , 2000, The Journal of social psychology.

[9]  P. Duberstein,et al.  Completed Suicide Among Older Patients in Primary Care Practices: A Controlled Study , 2000, Journal of the American Geriatrics Society.

[10]  R. Murray,et al.  Life events, ethnicity and perceptions of discrimination in patients with severe mental illness , 1999, Social Psychiatry and Psychiatric Epidemiology.

[11]  David R. Williams,et al.  The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. , 1999, Journal of health and social behavior.

[12]  T. Foster,et al.  Risk factors for suicide independent of DSM–III–R Axis I disorder , 1999, British Journal of Psychiatry.

[13]  Richard D. Harvey,et al.  Perceiving pervasive discrimination among African Americans: Implications for group identification and well-being. , 1999 .

[14]  L. Vijayakumar,et al.  Are risk factors for suicide universal? A case‐control study in India , 1999, Acta psychiatrica Scandinavica.

[15]  Hsiang-Ching Kung,et al.  Risk factors for suicide in Caucasians and in African-Americans: a matched case-control study , 1998, Social Psychiatry and Psychiatric Epidemiology.

[16]  H. Juon,et al.  Childhood, adolescent, and young adult predictors of suicidal behaviors: a prospective study of African Americans. , 1997, Journal of child psychology and psychiatry, and allied disciplines.

[17]  E. C. Harris,et al.  Suicide as an outcome for mental disorders , 1997, British Journal of Psychiatry.

[18]  D. Shaffer,et al.  Psychosocial risk factors of child and adolescent completed suicide. , 1996, Archives of general psychiatry.

[19]  D. Shaffer,et al.  Psychiatric diagnosis in child and adolescent suicide. , 1996, Archives of general psychiatry.

[20]  A. Cheng.  Mental illness and suicide. A case-control study in east Taiwan. , 1995, Archives of general psychiatry.

[21]  D. Brent,et al.  Suicide in affectively ill adolescents: a case-control study. , 1994, Journal of affective disorders.

[22]  D. Brent,et al.  Psychiatric risk factors for adolescent suicide: a case-control study. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[23]  P. Lewinsohn,et al.  Suicidal attempts among older adolescents: prevalence and co-occurrence with psychiatric disorders. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[24]  A. Beck,et al.  Clinical predictors of eventual suicide: a 5- to 10-year prospective study of suicide attempters. , 1989, Journal of affective disorders.

[25]  A. Derrick,et al.  Comorbidity of mental disorders in the post-mortem diagnosis of completed suicide in children and adolescents. , 1988, Journal of affective disorders.

[26]  A. Derrick,et al.  Psychological autopsy of completed suicide in children and adolescents. , 1985, The American journal of psychiatry.

[27]  O. McTigue,et al.  Single road traffic deaths--accident or suicide? , 1995, Crisis.

[28]  D. Clark,et al.  Assessment in absentia: The value of the psychological autopsy method for studying antecedents of suicide and predicting future suicides. , 1992 .