Publication date: May 09, 2024

To examine recent 12-year trends in prevalence of suicidal ideation and behaviors (SIBs) among US adults experiencing a past-year treatment-resistant depression (TRD). Using data from the National Survey of Drug Use and Health, we estimated the annual percentage of individuals aged ≥18 with TRD who reported past-year SIBs, and estimated linear trends adjusting for potentially confounding factors from 2009 to 2020. Of estimated 237. 5 million US adults, 7. 1 % met diagnostic criteria for a past-year major depressive episode (MDE) between 2009 and 2020. Of these, 9. 7 % met criteria for TRD. The proportion reporting past-year suicidal ideation in TRD ranged from 39. 5 % (95 % confidence interval [CI], 32. 1-47. 3 %) in 2009-2010 to 43. 4 % (95 % CI, 36. 7-503 %) in 2019-2020, with an average annual percent change (AAPC) of 1. 3 % (95 % CI, -0. 7 % to 3. 3 %). The prevalence of past-year suicide attempts in TRD was 7. 3 % across the study period (AAPC, 0. 1 %; 95 % CI, -4. 3 % to 4. 7 %). Past-year SIBs were significantly associated with an increased likelihood of meeting criteria for TRD among adults with MDE (adjusted odds ratio [AOR], 1. 53; 95 % CI, 1. 35-1. 75 for suicidal ideation; AOR, 2. 17; 95 % CI, 1. 79-2. 62 for suicide attempts). No significant differences were observed between 2019 and 2020, reflecting the COVID-19 pandemic. Among individuals with TRD, proportions of SIBs are high. These findings underscore an urgent need for suicide prevention efforts in this high-risk population, including preventive services across diverse settings and accessibility to evidence-based pharmacological and non-pharmacological interventions.

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