Which age groups have the highest prevalence of suicidal behaviors?

Updated: Sep 25, 2018
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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In general, the suicide rate increases with age, with a major spike in adolescents and young adults. In recent decades, the number of adolescent suicides has increased dramatically. The 2007 Youth Risk Behavior Surveillance showed that 6.9% of high school students had attempted suicide in the year before the survey. [92]

In a study of 6483 adolescents aged 13-18 years of age and their parents, Nock et al found lifetime prevalences of suicidal ideation, planning, and attempts of 12.1%, 4%, and 4.1%, respectively. Most meet the criteria for at least 1 DSM-IV disorder. This led them to conclude that suicidal behaviors are common among US adolescents. The rates are close to those found in adults. [93]

Although adolescents generally have a high suicide rate and are at risk, certain subcultures have an even higher risk. One such subculture is called "alternative," which includes individuals who describe themselves as "Goth," "Emo," and "Punk." Young and colleagues looked at 452 German school students aged 15 years. They found that teenagers who were in the alternative subgroup self-injured more frequently (45.5% vs 18.8%), repeatedly self-injured, and were 4-8 times more likely to attempt suicide (even after adjusting for social background). The study concluded that approximately half of these adolescents' self-injure, primarily to regulate emotions and to communicate distress. However, a minority self-injure to belong to the group. Alternatively, some subculture groups, such as "Jocks," channel anxieties into activities such as exercise. [94]

Nearly one-third of young people who die of suicide have nonfatal self-harm events during the last 3 months of life. One study found that adolescents and young adults were at markedly elevated risk of suicide after nonfatal self-harm. The 12-month suicide standardized mortality rate ratio after self-harm was significantly higher for adolescents (46.0, 95% confidence interval [CI]: 29.9–67.9) than young adults (19.2, 95% CI: 12.7–28.0). Among these high-risk patients, those who used violent self-harm methods, particularly firearms, were at especially high risk. [95]

With increasing age, a critical relationship emerges with suicide. Geriatric suicide is extremely prevalent. People older than 75 years have the highest rate of suicide. In 2007, the incidence of suicide in persons aged 75 years and older was 36.1 for every 100,000 people, compared with the national average of 11.26 suicides for every 100,000 people. [38] Suicide risk in various cities in England has been found to be 67 times higher for older adults (≥60 years) presenting with self-harm than for older adults in the general population. The highest suicide rates were found among men aged 75 years and older. [96] The older age group also maintains an alarming connection with murder-suicides. (Note the chart below for suicide figures based on sex, race, and age.) [97]

Rate of suicides in the United States by sex, race Rate of suicides in the United States by sex, race, and age. Courtesy of the US National Institute of Mental Health and the Centers for Disease Control and Prevention.

Suicide rates by age have historically noted peaks in the adolescent/young adult group and in the elderly. From 1999-2010, a significant increase (28.4%) was noted in the age-adjusted suicide rate for adults aged 35-64 years by 28.4%; the rate rose from 13.7 per 100,000 population to 17.6 (p< 0.001) Among men aged 35-64 years, the rate increased 27.3%, from 21.5 per 100,000 population to 27.3; the rate among women increased 31.5%, from 6.2 per 100,000 population to 8.1. The greatest increases among men were found in those aged 50-54 years and 55-59 years. Suicide rates increased with age among women, with the largest percentage increase found in those aged 60-64 years. [98]

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