ArticleJournal of psychiatric research2025
Geography and risk of suicidal ideation and attempts post outpatient psychiatric visit in commercially insured US adults.
Article in Journal of psychiatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Neighborhood-level social determinants of suicidality in youth with schizophrenia: An EHR-based study.Schizophrenia research · 2025Article
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Authors and funding
5 authors.
Funding
Abstract
objectiveThis study sought to determine whether demographic and clinical factors for suicidal ideation (SI) and suicide attempts (SA) in adults vary across different census divisions in the US.
methodsA nationwide cohort was constructed using commercial health insurance claims data of adults aged 25-64 years with at least one mental health or substance use disorder-related outpatient visit between 2014 and 2015. Survival analysis was used to study how the association of demographic and clinical factors on SI and SA vary by geographic divisions.
resultsThe Mountain Division had the highest rates of SI and SA in almost all observed time intervals after the index visit. The Northeast region and the West coast had the lowest rates. For both SI and SA, we observed strong interaction effects between geographic division and urbanicity (χ2(152) = 188.14, p = 0.02; χ2(152) = 196.20, p = 0.01, respectively). In particular, urbanicity was a risk factor for SI in the West North Central (HR = 0.71, 95% CI: [0.50, 0.99]) and the Pacific (HR = 0.54, 95% CI: [0.40, 0.74]) Divisions. Urbanicity was also a risk factor for SA in the West North Central Division (HR = 0.39, 95% CI: [0.16, 0.95]), but a protective factor for SA in the Mountain Division (HR = 1.71, 95% CI: [1.11, 2.63]).
conclusionsThe association between urbanicity and SI and SA varied by US geography. Future suicide prevention efforts should include a focus on urban adults in the West North Central and the Pacific Divisions, and rural adults in the Mountain Division.
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