Table 4.
Multivariate Associations of NSAL/DSM-IV Disorders With Subsequent First Onset of Attempted Suicide in the Total Sample and Disaggregated Through Pathways Involving Ideation, Plans, and Attempts
| Odds Ratio (95% Confidence Interval)* | |||||
|---|---|---|---|---|---|
| Attempt (n = 189)† |
Ideation (n = 542)† |
Plan Among Ideators (n = 190)‡ |
Impulsive Attempt Among Ideators Without a Plan (n = 72)‡ |
Planned Attempt Among Ideators With a Plan (n = 117)‡ |
|
| Any disorder | 8.19 (4.77–14.06)§ | 4.96 (3.48–7.06)§ | 2.37 (1.34–4.19)§ | 1.59 (0.66–3.82) | 2.16 (0.54–8.62) |
| Mood disorders | |||||
| Any mood disorder | 3.83 (2.77–5.30)§ | 4.11 (3.23–5.24)§ | 1.35 (0.88–2.06) | 0.97 (0.49–1.93) | 0.87 (0.45–1.67) |
| Major depressive disorder | 3.80 (2.80–5.16)§ | 3.83 (3.09–4.74)§ | 1.31 (0.93–1.83) | 0.98 (0.48–1.99) | 0.92 (0.55–1.54) |
| Dysthymia | 6.24 (3.70–10.52)§ | 4.84 (3.41–6.89)§ | 1.17 (0.71–1.92) | 2.79 (1.26–6.17)* | 1.11 (0.56–2.21) |
| Bipolar I–II disorder (Includes sub-threshold) | 3.59 (2.12–6.09)§ | 3.07 (1.96–4.81)§ | 1.69 (0.66–4.36) | 1.15 (0.39–3.38) | 1.61 (0.79–36.28) |
| Anxiety disorders | |||||
| Any anxiety disorder | 6.03 (3.77–9.64)§ | 4.02 (3.24–4.99)§ | 1.69 (1.04–2.74)§ | 1.70 (0.91–3.17) | 1.76 (1.02–3.03) |
| Panic disorder | 5.34 (3.11–9.17)§ | 4.15 (2.78–6.21)§ | 1.38 (0.62–3.07) | 1.24 (0.47–3.31) | 1.49 (0.74–3.00) |
| Agoraphobia without panic | 2.67 (1.26–5.66)§ | 2.08 (1.24–3.50)§ | 0.94 (0.27–3.31) | 1.28 (0.34–4.82) | 2.14 (0.69–6.62) |
| Social phobia | 2.43 (1.25–4.70)§ | 2.27 (1.55–3.32)§ | 1.08 (0.46–2.54) | 1.30 (0.58–2.91) | 1.03 (0.54–1.94) |
| Generalized anxiety disorder | 4.16 (2.41–7.20)§ | 3.84 (2.68–5.50)§ | 1.33 (0.73–2.44) | 1.05 (0.43–2.54) | 1.40 (0.73–2.70) |
| Obsessive-compulsive disorder∥ | 5.30 (2.01–13.99)§ | 5.03 (3.32–7.61)§ | 1.06 (0.44–2.58) | 1.19 (0.34–4.16) | 1.08 (0.41–2.83) |
| Posttraumatic stress disorder | 5.89 (3.81–9.08)§ | 4.02 (3.18–5.08)§ | 1.78 (1.08–2.94)§ | 2.05 (1.06–3.99) | 1.66 (1.01–2.74) |
| Substance disorders | |||||
| Any substance disorder | 4.53 (3.02–6.80)§ | 3.11 (2.38–4.08)§ | 1.14 (0.70–1.87) | 1.56 (0.77–3.17) | 1.51 (0.83–2.76) |
| Alcohol abuse | 4.75 (3.10–7.29)§ | 3.26 (2.47–4.31)§ | 1.01 (0.66–1.57) | 1.46 (0.71–3.01) | 1.47 (0.79–2.73) |
| Alcohol dependence | 5.65 (3.45–9.26)§ | 3.97 (2.78–5.66)§ | 0.67 (0.30–1.49) | 2.29 (1.05–4.97) | 1.68 (0.71–4.00) |
| Drug abuse | 5.18 (3.37–7.97)§ | 2.99 (2.10–4.26)§ | 1.18 (0.68–2.05) | 1.30 (0.58–2.92) | 2.05 (1.06–3.98) |
| Drug dependence | 6.34 (3.17–12.69)§ | 3.15 (1.83–5.44)§ | 1.03 (0.18–5.96) | 2.19 (0.86–5.53) | 1.92 (0.81–4.56) |
| Childhood disorders | |||||
| Any childhood disorder | 4.25 (3.02–5.99)§ | 3.14 (2.44–4.03)§ | 1.42 (0.89–2.27) | 2.49 (1.06–5.82)* | 1.47 (0.69–3.10) |
| Separation anxiety disorder | 3.59 (1.90–6.82)§ | 3.09 (2.25–4.26)§ | 1.38 (0.67–2.81) | 1.47 (0.59–3.69) | 1.63 (0.81–3.29) |
| Oppositional-defiant disorder | 2.48 (1.42–4.32)§ | 2.05 (1.51–2.78)§ | 1.76 (0.99–3.12) | 1.28 (0.47–3.46) | 1.94 (0.87–4.31) |
| Conduct disorder | 4.98 (3.28–7.57)§ | 3.18 (2.28–4.44)§ | 1.64 (0.99–2.72) | 2.87 (1.35–6.11)* | 1.90 (0.98–3.69) |
| Attention-deficit/hyperactivity disorder | 6.20 (3.75–10.26)§ | 3.78 (2.65–5.39)§ | 1.55 (0.80–3.02) | 2.25 (0.86–5.87) | 3.06 (1.52–6.19)* |
| Eating disorders | |||||
| Any eating disorder | 3.15 (1.83–5.45)§ | 2.87 (2.06–4.00)§ | 1.71 (0.75–3.91) | 1.79 (0.29–10.94) | 1.30 (0.65–2.59) |
| Anorexia¶ | 10.29 (1.96–54.18)§ | 3.88 (0.86–17.59) | Unestimable | 15.30 (2.41–97.08)* | Unestimable |
| Bulimia | 2.71 (0.84–8.72) | 2.84 (1.40–5.77)* | 2.42 (0.50–11.78) | 3.71 (1.01–13.60) | 0.77 (0.17–3.50) |
| Binge-eating | 3.23 (1.88–5.54)§ | 2.93 (2.06–4.17)§ | 1.72 (0.71–4.19) | 1.83 (0.77–4.35) | 1.30 (0.65–2.59) |
| No. of comorbid disorders | |||||
| 0 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| 1 | 3.95 (2.12–7.37)§ | 2.62 (1.67–4.12)§ | 2.41 (1.48–3.94)§ | 1.21 (0.31–4.66) | 1.73 (0.66–4.58) |
| 2 | 4.94 (2.22–10.99)§ | 3.98 (2.93–5.42)§ | 1.97 (0.99–3.92) | 1.15 (0.16–8.44) | 1.37 (0.46–4.07) |
| ≥3 | 17.13 (9.32–31.47)§ | 9.74 (6.80–13.95)§ | 2.51 (1.25–5.05)§ | 2.05 (0.77–5.49) | 2.68 (1.12–6.40) |
Abbreviations: DSM–IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; NSAL, National Survey of American Life.
Odds ratios were obtained by exponentiating the coefficients from Cox proportional hazards regression models. The 95% confidence intervals were obtained using a modified method of balanced repeated replications to adjust for stratification, clustering, and weighting of the data. Each column presents the results from 27 models. Each of these models controlled for the sociodemographic variables presented in Table 2. In addition, each model contained exactly 1 of the 20 individual disorders, exactly 1 of the 6 summary measures (any disorder, any mood disorder, etc.), or the set of dummy variables representing the number of comorbid disorders. All disorders were defined without diagnostic hierarchy rules.
The behavioral categories of attempt and ideation present the risks for the unconditional behaviors.
The behavioral categories of plan among ideators, impulsive attempt among ideators without a plan, and planned attempt among ideators with a plan present the risks for the conditional behaviors.
Indicates odds ratio estimates that are significantly different from 1.00 using the false discovery rate method of adjusting for multiple comparisons. For the 145 tests in this table, this significance criterion was P<.0231. Confidence intervals remain unadjusted. As a result, it is possible for an odds ratio to be nonsignificant by this criterion even though 1.00 lies outside of the corresponding 95% confidence interval.
This obsessive compulsive diagnosis is based on the World Mental Health Composite International Diagnostic Interview Short Form and should be considered a probable diagnosis.
Only a small number of respondents met criteria for anorexia. As such, these risk coefficients tend to be artificially high, low, or unestimable.