Depression leading to suicide in United States: A retrospective analysis of CDC WONDER from 1999 to 2022

Depressive disorder is a prevalent mental health condition in the United States, where suicide has been a leading cause of death among depressive patients. This study aimed to analyze suicide mortality trends in depressive disorder patients in the U.S. from 1999 to 2022.

Data were extracted from the CDC WONDER database, identifying depression-related and suicide-related deaths using ICD-10-CM codes (F32, F33, F41.2, F92.0) and ICD-10-CM codes (U03, X60-X84, Y87.0) respectively. Age-adjusted mortality rates (AAMRs) per 1,000,000 and annual percent changes (APCs) were calculated and stratified by year, gender, age-group, race/ethnicity, region, and urbanization status.

A total of 57,103 deaths due to suicide and depressive disorder were analyzed. From 1999 to 2022, the AAMR significantly increased from 1999 to 2015 (APC: 2.05; 95 % CI: 1.65-2.74; p < 0.0001), followed by a stable trend from 2015 to 2022 (APC: 0.81; 95 % CI: 3.67 to 0.36; p = 0.14). Men consistently exhibited higher AAMRs (10) than women (3.9), with particularly highest rates observed in the 50-59 age group (11.2). Non-Hispanic (NH) White individuals had the highest AAMRs (9.9), followed by NH American Indian/Alaska Native populations (3.7), and NH Black individuals exhibiting the lowest rates (1.9). Rural areas showed significantly higher rates (12.5) compared to urban areas (5.4), with the Western U.S. region experiencing the steepest increases [Average Annual Percent Change (AAPC): 2.44; 95 % CI: 1.76 to 3.49].

This study reveals critical demographic and geographic disparities in suicide and depression-related mortality. Addressing the disproportionate burden on high-risk groups can guide future preventive strategies to mitigate the rising trends (Central Illustration).