Suicide categories by patterns of known risk factors: A latent class analysis

Multiple risk factors often contribute to suicides; however, patterns of co-occurrence among these factors have not been fully identified. To help focus prevention strategies, we identified patterns, or classes, of known suicide-related risk factors, categorized suicide decedents by these classes, tracked class proportions over a 6-year period, and characterized decedents across the classes. To meet these objectives, latent class analysis (LCA) was conducted using data from the National Violent Death Reporting System, 2003-2008 data years. The study population included 28,703 suicide decedents from 12 U.S. states. Factors used for the LCA included having mental health conditions, a sad/depressed mood, substance abuse problems, medical problems, a recent crisis, financial problems, legal problems, intimate partner problems, and other relationship problems. Based on these factors, nine distinct classes of risk factors emerged. One class only endorsed mental health-related factors and one only endorsed alcohol/substance abuse factors; however, seven classes of decedents had distinct patterns of factors that spanned multiple domains. Five of these classes had mental health factors with other risks (e.g., substance abuse, financial problems, relationship problems, a recent crisis, and medical problems). Two classes had recent crises with relationship problems; one of these also had legal problems with records of interpersonal violence. Class proportions differed over the years. Differences across classes by demographic and event characteristics were also found. These findings indicate that there are common patterns of co-occurring factors that precede suicide and that most suicide decedents needed more connected services across medical, mental health/substance abuse, and court/social service systems prior to death.