Recovery from past suicide attempts: Correlates of time since the last attempt in a national sample of US adults

Background
This study takes a lifetime perspective on suicide attempts and examines correlates of years since the last attempt as a potential proxy for recovery from suicidality.
Methods
Data from 36,309 adults in the National Epidemiologic Survey on Alcohol and Related Conditions-III were used to identify 1,924 respondents (5.3%) who reported a lifetime suicide attempt. Measures included socio-demographics, behavioral factors, and DSM-5 diagnoses, as well as the age at first attempt. Bivariate and multivariate analyses were used to adjust for potentially confounding effects of age and to identify independent factors associated with not attempting suicide for >1-5 years or >5 years.
Results
Of those who reported a lifetime suicide attempt, 7.9% reported their most recent attempt in the past year, 18.6% within 1 to 5 years, and 73.5% in greater than 5 years. While absence of lifetime substance use disorder and past year psychiatric disorder prominently characterized those with no attempt in the past 1 to 5 years, many more sociodemographic advantages additionally characterized those whose last attempt was >5 years ago, including being older, married, employed, higher incomes, no recent homelessness or criminal justice involvement, more social contacts, as well as having less past year substance use or psychiatric disorders.
Limitations
The retrospective, self-report design introduces the possibility of recall bias.
Conclusions
Almost three-fourths of people with lifetime suicide attempts have not attempted for more than 5 years. Recovery involves not only psychiatric and substance use disorders but improvements in key socio-demographics and social connectedness over many years.