Persons With Debt Burden Are More Likely to Report Suicide Attempt Than Those Without: A National Study of US Adults

Diana E. Naranjo, MPH^a,c ; Joseph E. Glass, MSW, PhD^b ; Emily C. Williams, MPH, PhD^a,b,c

J Clin Psychiatry 2021;82(3):19m13184

ABSTRACT

Objective: To assess the association between debt burden and self-reported suicide attempt among US adults.

Methods: Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012–2013) were used to estimate the association between self-reported past-year debt burden and past-year and lifetime suicide attempt with logistic regression, controlling for sociodemographic characteristics with known associations with debt burden and suicide attempt.

Results: Among 36,278 adults aged ≥ 18 years, 13.03% reported past-year debt burden, 0.37% reported past-year suicide attempt, and 5.16% reported lifetime suicide attempt. Self-reported attempt was more likely for persons reporting debt burden than for those without (eg, for past-year suicide attempt: odds ratio [OR] = 7.96 [95% CI, 5.45–11.64; P < .001] when unadjusted; OR = 3.39 [95% CI, 2.15–5.34; P < .001] when adjusted for sociodemographic variables and mood disorders). The adjusted prevalence of past-year suicide attempt for those with and without debt burden was 0.75% (95% CI, 0.50%–1.00%) and 0.23% (95% CI, 0.17%–0.29%), respectively.

Conclusions: Debt burden is strongly associated with increased likelihood of suicide attempt. The strength of the identified association is comparable to or greater than that for other major predictors of suicide (eg, sex) and other mortality risk factors (eg, smoking, obesity). Findings highlight debt burden as a strong social determinant of suicide risk and intervention target.

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