Importance  A recent increase in suicide in the United States has raised public and clinical interest in determining whether a coincident national increase in suicide attempts has occurred and in characterizing trends in suicide attempts among sociodemographic and clinical groups.

Objective  To describe trends in recent suicide attempts in the United States.

Design, Setting, and Participants  Data came from the 2004-2005 wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the 2012-2013 NESARC-III. These nationally representative surveys asked identical questions to 69 341 adults, 21 years and older, concerning the occurrence and timing of suicide attempts. Risk differences adjusted for age, sex, and race/ethnicity (ARDs) assessed trends from the 2004-2005 to 2012-2013 surveys in suicide attempts across sociodemographic and psychiatric disorder strata. Additive interactions tests compared the magnitude of trends in prevalence of suicide attempts across levels of sociodemographic and psychiatric disorder groups. The analyses were performed from February 8, 2017, through May 31, 2017.

Main Outcomes and Measures  Self-reported attempted suicide in the 3 years before the interview.

Results  With use of data from the 69 341 participants (42.8% men and 57.2% women; mean [SD] age, 48.1 [17.2] years), the weighted percentage of US adults making a recent suicide attempt increased from 0.62% in 2004-2005 (221 of 34 629) to 0.79% in 2012-2013 (305 of 34 712; ARD, 0.17%; 95% CI, 0.01%-0.33%; P = .04). In both surveys, most adults with recent suicide attempts were female (2004-2005, 60.17%; 2012-2013, 60.94%) and younger than 50 years (2004-2005, 84.75%; 2012-2013, 80.38%). The ARD for suicide attempts was significantly larger among adults aged 21 to 34 years (0.48%; 95% CI, 0.09% to 0.87%) than among adults 65 years and older (0.06%; 95% CI, −0.02% to 0.14%; interaction P = .04). The ARD for suicide attempts was also significantly larger among adults with no more than a high school education (0.49%; 95% CI, 0.18% to 0.80%) than among college graduates (0.03%; 95% CI, −0.17% to 0.23%; interaction P = .003); the ARD was also significantly larger among adults with antisocial personality disorder (2.16% [95% CI, 0.61% to 3.71%] vs 0.07% [95% CI, −0.09% to 0.23%]; interaction P = .01), a history of violent behavior (1.04% [95% CI, 0.35% to 1.73%] vs 0.00% [95% CI, −0.12% to 0.12%]; interaction P = .003), or a history of anxiety (1.43% [95% CI, 0.47% to 2.39%] vs 0.18% [95% CI, 0.04% to 0.32%]; interaction P = .01) or depressive (0.99% [95% CI, −0.09% to 2.07%] vs −0.08% [95% CI, −0.20% to 0.04%]; interaction P = .05) disorders than among adults without these conditions.

Conclusions and Relevance  A recent overall increase in suicide attempts among adults in the United States has disproportionately affected younger adults with less formal education and those with antisocial personality disorder, anxiety disorders, depressive disorders, and a history of violence.

重要性  最近美国自杀人数的增加引起了公众和临床的兴趣，以确定全国范围内自杀企图是否同步增加，以及社会人口和临床群体中自杀企图趋势的特征。

目的  描述美国近期自杀未遂的趋势。

设计、设置和参与者  数据来自 2004-2005 年第二波全国酒精及相关疾病流行病学调查 (NESARC) 和 2012-2013 年 NESARC-III。这些具有全国代表性的调查向 69 341 名 21 岁及以上的成年人提出了有关自杀未遂的发生和时间的相同问题。根据年龄、性别和种族/族裔 (ARD) 调整的风险差异评估了 2004-2005 年至 2012-2013 年社会人口和精神疾病阶层自杀未遂调查的趋势。加性相互作用测试比较了不同社会人口和精神疾病群体的自杀未遂流行趋势的大小。这些分析是在2017年2月8日至2017年5月31日期间进行的。

主要结果和措施  自述在访谈前 3 年尝试过自杀。

结果  通过使用 69 341 名参与者（42.8% 男性和 57.2% 女性；平均 [SD] 年龄，48.1 [17.2] 岁）的数据，最近尝试自杀的美国成年人的加权百分比从 2004 年的 0.62% 增加到2005 年（34 629 中的 221）下降到 2012-2013 年的 0.79%（34 712 中的 305；ARD，0.17%；95% CI，0.01%-0.33%；P  = .04）。在这两项调查中，大多数近期自杀未遂的成年人都是女性（2004-2005年，60.17%；2012-2013年，60.94%）和50岁以下（2004-2005年，84.75%；2012-2013年，80.38%）。21 至 34 岁成年人自杀未遂的 ARD（0.48%；95% CI，0.09% 至 0.87%）显着高于 65 岁及以上成年人（0.06%；95% CI，-0.02% 至 0.14%） ；相互作用P  = .04)。高中以下学历的成年人自杀未遂的 ARD 也显着高于大学毕业生（0.03%；95% CI，-0.17% 至 0.23）（0.49%；95% CI，0.18% 至 0.80%）。 %；相互作用P  = .003)；患有反社会人格障碍的成年人的 ARD 也显着更大（2.16% [95% CI, 0.61% to 3.71%] vs 0.07% [95% CI, -0.09% to 0.23%]；交互作用P  = 0.01），暴力行为史（1.04% [95% CI，0.35% 至 1.73%] vs 0.00% [95% CI，-0.12% 至 0.12%]；交互作用P  = .003），或焦虑史（1.43% [ 95% CI, 0.47% to 2.39%] vs 0.18% [95% CI, 0.04% to 0.32%]；交互作用P  = .01) 或抑郁（0.99% [95% CI, −0.09% to 2.07%] vs − 0.08% [95% CI, −0.20% 至 0.04%]；交互作用P  = .05) 疾病比没有这些疾病的成年人少。

结论和相关性  最近，美国成年人自杀未遂的总体增加对受教育程度较低的年轻人以及患有反社会人格障碍、焦虑症、抑郁症和暴力史的年轻人造成了不成比例的影响。