were related to the presence of suicidal behaviors or mental disorders, which could have biased cross-national comparisons. Third, there may have been cross-national differences in the willingness to report on suicidal behaviors and in the interpretation of items assessing risk factors. Significant efforts were dedicated to carefully translating and back-translating the WHO-CIDI used in this study in order to minimize such concerns;36 however, differences in factors such as the stigma about suicide and childhood maltreatment are likely to persist cross-nationally despite these efforts. Fourth, although we examined a broad set of potential risk factors, many important factors were not included in this study. Psychotic disorders, although known to be associated with suicidal behavior, were not assessed because prior studies have shown that they are dramatically overestimated using structured interviews such as the WMH-CIDI.70, 71 We also did not include many family history (e.g., history of schizophrenia or bipolar disorder), psychological (e.g., hopelessness), social (e.g., lack of social support) or biological (e.g., serotonergic functioning) factors known to be associated with suicidal behaviors. Any one study cannot assess all such factors; however, the limited focus used is important to bear in mind when interpreting the results.
