Evaluation of Suicidal Ideation in the National Health and Wellness Survey (NHWS): A Focus on Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD)

Background: Suicidal ideation (SI) is a growing public health issue, particularly among individuals with mental health conditions. This study examines the prevalence of SI among a sample population of U.S. adults, focusing on those reporting symptoms of GAD and MDD.
Methods: Data from the 2022 NHWS, a cross-sectional, nationally-representative, online survey, were analyzed. Question 9 of the PHQ-9 survey in the NHWS evaluated the existence of SI among adults with GAD only (GAD-7 scale) and both GAD and MDD (PHQ-9). Results were weighted to match the demographic composition of the US adult population based on the 2021 US Census Bureau and stratified by severity using the GAD-7 scale.
Results: In 2022, 28.4% of adults reported some level of SI. Any SI (≥ several days or more in past two weeks) was highest among young adults (18-34; 47%), males (33%), Hispanic (48%) and students (43%). 23% of the total population reported moderate to severe GAD symptoms, and increasing GAD severity was associated with increasing SI frequency. While more than half of respondents with GAD symptoms also have depressive symptoms, those individuals with moderate to severe GAD and no depression symptoms reported elevated levels of SI, 78.0% and 91%, respectively. 50% of those with severe GAD and MDD reported SI nearly every day.
Conclusion: SI is highly prevalent in the U.S., particularly among individuals with GAD and MDD, and increases with GAD symptom severity. These findings emphasize the importance of thorough screening for SI among patients with GAD and GAD and MDD.