The Urgent Need for Social Change: National Estimates of Suicidality in Five Demographic Groups of Adults with and without Major Depression

Background/Purpose: Over 50% of people who die by suicide suffer from major depression. A relatively high rate of suicidality continues to accelerate in the general population and presses the question about recent national prevalence estimates of major depression and suicidal thoughts and attempts in increasingly diverse American society. Previous studies that examined major depression and suicide included confounding variables that masked the true prevalence rates of major depression and suicidal thoughts and attempts within demographic groups.

To provide recent and accurate national prevalence rates of suicidal thoughts and attempts in diverse demographic U.S population, we used the 2018 National Survey on Drug Use and Health (NSDUH). In our study we extracted data from the most recent NSDUH survey to analyze national prevalence rates of suicidal thoughts and attempts among adults with and without Major Depressive Episode (MDE) symptoms in five demographic groups: sex by race, age, educational level and marital status.

Due to the growing diversity in the U.S population, our study contributes to the field by deepening our understanding of major depression and suicide national rates in demographic groups to inform policy makers and practitioners about population based policy and practice planning to reduce rates of depression and suicide.

Methods: Data and sample: The NSDUH survey is a stratified national sample that is selected using five-stage stratified sample design. The data has been weighted to obtain unbiased estimates for survey outcomes in the population represented in the NSDUH survey. Study subjects were 18 years and older, with or without MDE based on the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, 5^th edition (DSM-5). Data from the survey was extracted, reaching 42,551 non-institutionalized individuals representing a weighted total of 246,262,418.554 population size.

Measures: The main independent variables in the study were sex by race, age, educational level and marital status. The outcome measures included suicidal thoughts and suicidal attempts among adults. Suicidal thoughts were assessed by questions over suicidal thoughts the individual had during the past 12 months, whereas suicidal attempts were measured by questions about attempts to kill oneself.

Results: Results show high prevalence rates of suicidal thoughts and attempts among adults with and without MDE. The highest rates of suicidal thoughts and attempts found in adults with MDE among White females (40.6%; 36%), the 18-25 age group (36.4%; 45.6%), adults with some college education (38.7%; 32.8%) and single adults (57.1%; 64.8%). Among adults without MDE, high proportions of suicidal thoughts (and similar number for attempts) were found among White males (31.9%), adults with some college education (39%) and single adults (49.5%). A chi-square test results indicate a significant MDE distribution differences across the five demographic groups (p < 0.001).

Conclusions and Implications: Research findings show an alarmingly high rates of major depression and suicidal thoughts and attempts in most demographic groups. Such findings press the urgency to tailor population-based mental health policies and interventions to sharply reduce the estimate rates of depression and suicide in the American society.