Ethnicity Modifies the Additive Effects of Anxiety and Drug Use Disorders on Suicidal Ideation among Black Adults in the United States

BACKGROUND: This study aimed to test if ethnicity moderates the additive effects of lifetime psychiatric disorders on serious suicidal thoughts among a nationally representative sample of Black adults in the United States. METHODS: For this study, we used data of 5,181 Black adults (3,570 African Americans and 1,621 Caribbean Blacks) who participated in the National Survey of American Life, 2001-2003. Five lifetime psychiatric disorders (i.e., major depressive disorder, general anxiety disorder, post-traumatic stress disorder, alcohol abuse disorder, and drug abuse) were considered as the independent variables. Lifetime serious suicidal ideation was considered as the dependent variable. Logistic regressions were used to determine if ethnicity modifies the effects of each psychiatric disorder on serious suicide ideation. Ethnicity was conceptualized as the possible moderator and socio-demographics (i.e., age, gender, education level, employment, marital status and country region) were control variables. RESULTS: Among African Americans, major depressive disorder, general anxiety disorder, post-traumatic stress disorder and alcohol abuse disorder were associated with higher odds of suicidal thoughts. Among Caribbean Blacks, major depressive disorder and drug abuse disorder were associated with higher odds of suicidal thoughts. In the pooled sample, there was a significant interaction between ethnicity and anxiety disorder and a marginally significant interaction between ethnicity and drug abuse. CONCLUSIONS: Based on our study, suicidality due to psychiatric disorders among Black adults in the United States may depend on ethnicity. General anxiety disorder seems to be a more important risk factor for suicidal ideation among African Americans while drug abuse may contribute more to the risk of suicidal thoughts among Caribbean Blacks.