Prevalence and correlates of inconsistent reporting of lifetime suicidal ideation and attempts in a large cohort of Australian males.

BACKGROUND: Reliable data on suicidal ideation, attempts, and deaths are essential for effective suicide prevention. However, prior research indicates that up to one-third of individuals inconsistently recall past self-injurious thoughts and behaviors, raising concerns about underestimation of suicide risk. Evidence on the prevalence and correlates of inconsistent reporting of suicidal ideation and attempts in large population-based cohorts, particularly among men, remains limited. OBJECTIVE: To estimate the prevalence and identify correlates of inconsistent reporting of lifetime suicidal ideation and attempts among Australian men. METHODS: Data were drawn from Ten to Men: The Australian Longitudinal Study on Male Health. Our primary analyses focused on 1,880 men who reported lifetime suicidal ideation and 508 who reported lifetime suicide attempt at Wave 1 and followed up at Wave 2. Inconsistent reporting was defined as endorsing lifetime suicidality at Wave 1 but not at Wave 2. Modified Poisson regression was used to investigate correlates of inconsistent reporting, based on broad set of sociodemographic, psychosocial, and clinical characteristics. Wave 3 analyses were conducted as exploratory sensitivity checks. RESULTS: At Wave 2, 17.3% (95% CI: 15.6%-20.6%) of those who had reported suicidal ideation and 34.6% (95% CI: 30.5%-38.7%) of those who had reported a suicide attempt no longer reported these histories. Wave 3 analyses showed similar patterns. Depressive symptoms were associated with lower likelihood of inconsistent reporting of suicidal ideation (PR=0.54, 95% CI: 0.38-0.76, p<0.001). Other hypothesized factors were not significantly associated with inconsistent reporting. CONCLUSION: Inconsistent reporting of suicidal ideation and attempts is common among Australian men. Findings highlight the need for improved measurement strategies in longitudinal suicide research.