Likelihood of suicidality at varying levels of depression severity: a re-analysis of NESARC data

Although it is clear that increasing depression severity is associated with more risk for suicidality, less is known about at what levels of depression severity the risk for different suicide symptoms increases. We used item response theory to estimate the likelihood of endorsing suicide symptoms across levels of depression severity in an epidemiological data set. Regardless of depression severity, suicide attempts were less frequently endorsed than ideation, which was less frequently endorsed than feeling like one wanted to die. All suicide symptoms were generally less likely to be endorsed than other depression symptoms. There was a low probability of suicidality at depression levels that likely would not merit a diagnosis of major depression.