In the US, more than one million people attempt suicide each year. History of suicide attempt is a significant risk factor for death by suicide; however, there is a paucity of data from the US general population on this relationship. The objective of this study was to examine suicide attempts needing medical attention as a risk for suicide death. We conducted a case-control study involving eight US healthcare systems. A total of 2,674 individuals who died by suicide from 2000 to 2013 were matched to 267,400 individuals by year and location. Prior suicide attempt associated with a medical visit increases risk for suicide death by 39.1 times, particularly for women ( = 79.2). However, only 11.3% of suicide deaths were associated with an attempt that required medical attention. The association was the strongest for children 10-14 years old ( = 98.0). Most suicide attempts were recorded during the 20-week period prior to death. Our study is limited to suicide attempts for which individuals sought medical care. In the US, prior suicide attempt is associated with an increased risk of suicide death; the risk is high especially during the period immediately following a nonlethal attempt.
Serious Suicide Attempts and Risk of Suicide Death.