Epidemiology of completed and attempted suicide: toward a framework for prevention

Abstract

Suicide is an important public health problem. It is a complex, long-term outcome of mental illness, with multiple, interacting antecedents. This paper reviews descriptive and analytic epidemiologic studies of completed and attempted suicide, discusses the primary sources of epidemiologic data, and describes the major risk factors for completed and attempted suicide. Risk factors are described within a framework that distinguishes between distal and proximal, and individual and environmental antecedents. Organization of our knowledge of risk and protective factors for both completed and attempted suicide provides opportunities to develop and implement life-saving preventive strategies.