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兴趣，以确定是否发生了同时发生的全国自杀未遂事件，并确定了社会人口统计学和临床​​人群中自杀未遂的趋势。

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。这些全国代表性的调查向21341岁以上的69341名成年人提出了相同的问题，涉及自杀未遂的发生和时间。根据年龄，性别和种族/民族（ARD）进行调整后的风险差异，评估了2004年至2005年至2012年至2013年在社会人口统计学和精神病学分层中未遂自杀调查的趋势。加性相互作用测试比较了社会人口学和精神病学人群中自杀未遂率的趋势。分析是从2017年2月8日到2017年5月31日进行的。

主要结果和措施  在面试前的三年中，自我报告的自杀未遂。

结果  利用来自69 341名参与者的数据（男性为42.8％，女性为57.2％；平均[SD]年龄为48.1 [17.2]岁），最近尝试自杀的美国成年人的加权百分比从2004年的0.62％上升到2005年（34 629的221）增至2012-2013年的0.79％（347的305; ARD，0.17％; 95％CI，0.01％-0.33％; P  = 0.04）。在这两项调查中，大多数近期自杀未遂的成年人是女性（2004-2005年，60.17％； 2012-2013年，60.94％）和50岁以下的年轻人（2004-2005年，84.75％； 2012-2013年，80.38％）。21至34岁成年人的自杀未遂ARD（0.48％; 95％CI，0.09％至0.87％）比65岁及以上成年人（0.06％; 95％CI，-0.02％至0.14％ ;互动P = .04）。高中以上文化程度的成年人的自杀未遂ARD（0.49％; 95％CI，0.18％to 0.80％）也比大学毕业生（0.03％; 95％CI，-0.17％to 0.23）大得多％；互动性P  = 0.003）；在患有反社会人格障碍的成年人中，ARD的比例也显着较高（2.16％[95％CI，0.61％至3.71％]与0.07％[95％CI，-0.09％至0.23％]；交互作用P  = .01），暴力行为史（1.04％[95％CI，0.35％to 1.73％] vs 0.00％[95％CI，-0.12％to 0.12％];互动P  = 0.003），或有焦虑史（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）或抑郁症（0.99％[95％CI，-0.09％至2.07％] vs -0.08％[95％CI，-0.20％至0.04％]；相互作用P  = .05）条件。

结论与相关性  最近在美国成年人中自杀未遂总体增加，对受过较少正规教育的年轻人和反社会人格障碍，焦虑症，抑郁症以及有暴力史的成年人的影响不成比例。