Socioeconomic Inequalities in the Continuum of Suicidal Ideation

Background: Suicidal ideation changes over time. Few studies have examined socioeconomic inequalities in suicide ideation regarding interrelated indicators of incidence, persistence, and remission. Aim: We aimed to investigate how socioeconomic characteristics are related to the incidence, persistence, and remission of suicidal ideation in South Korea. Methods: We assessed the incidence of suicidal ideation at the 1-year follow-up among individuals without prior suicidal ideation and its persistence and remission at the 2-year follow-up. We conducted a multinomial logistic regression analysis to examine the association between SES and three indicators of the course of suicidal ideation. Results: Among 8,334 respondents, the 12-month incidence of suicidal ideation was 2.1%. Among these cases, 18.5% persisted, while 81.5% remitted. Low SES, particularly income, was strongly associated with the incidence, persistence, and remission of suicidal ideation. The socioeconomic association was strongest for persistent suicidal ideation (adjusted odds ratio [aOR]: 3.66; 95% confidence interval [CI]: 1.47-9.10), followed by incidence (aOR: 1.59; 95% CI: 1.10-2.29) and remission (aOR: 1.32; 95% CI: 0.88-1.97) of suicidal ideation. Limitations: We could not examine changes in these risk factors during the follow-up period. Conclusion: Adverse socioeconomic circumstances may precipitate the worsening in the course of suicidal ideation. Addressing the socioeconomic determinants of suicidal ideation should be prioritized.