Suicide History and Mortality: A Follow-Up of a National Cohort in the United States

Little is known about the cause-specific deaths among young suicide attempters from the general population, and the time window for intervention to reduce the elevated rate of death was unclear. We analyzed a nationally representative sample of young adults (17–39 years old) who participated in the third National Health and Nutrition Examination Survey (NHANES III, 1988–1994) and were followed up with vital status through December 31, 2006. The history of attempted suicide was associated with an increased rate for all-cause death (HR = 1.52 [95% CI = 0.92–2.52]) with borderline statistical significance. Previous suicide attempters experienced a 3-fold (HR = 2.68[=1.01–7.09]) increased rate for cardiovascular diseases (CVD), and a 7-fold (HR = 7.10 [95% CI = 1.37–36.9]) increased rate of death due to completed suicide compared with non-attempters. The survival curves of the attempters declined rapidly for the first 3 years of follow-up, and the distance between curves remained consistent starting from the third year to the end of the follow-up. Prevention services should be tailored not only for suicide, but also for cardiovascular diseases among populations with suicidal tendency, and the service should be intensified within first 3 years after suicidal behaviors occur.