Prevalence and Gender Differences in Suicidal Behavior: A Large-Scale Cross-Sectional Study in India and Measurement Invariance of the Suicidal Behaviors Questionnaire-Revised

Background: Suicide is one of the leading public health issues that needs public attention and remains a primary cause of injury-related morbidity and mortality globally. Evidence suggests that suicidal behaviors are substantially more prevalent than indicated by official statistics, as suicides are sometimes underreported or misclassified due to social and cultural factors. Consequently, the true burden of suicidal behaviors may be substantially underestimated. The aim of the present study was to assess the psychometric evaluation and measurement invariance of the Suicidal Behaviors Questionnaire-Revised (SBQ-R) across gender, and to examine the prevalence and gender differences in suicidal behaviors in a large community-based sample from India. Method and Design: It was a cross-sectional study conducted among 1,565 participants aged 18 to 60 years, representing both genders, recruited via snowball and convenience sampling. All participants completed the SBQ-R. Results: The SBQ-R demonstrated acceptable psychometric properties, including convergent validity and adequate internal consistency. A unidimensional model was confirmed through confirmatory factor analysis, demonstrating a satisfactory model fit. In addition, the measurement invariance test supported configural, metric, and scalar invariance across gender. The overall prevalence of suicidal behavior was 23.9%, with a significantly higher prevalence among women (16.8%) than men (7.1%). Furthermore, 25.4% of participants reported lifetime suicidal ideation, followed by suicidal planning (11.0%) and suicide attempts (5.6%). Conclusion: The SBQ-R is a reliable and valid tool for measuring suicidal behaviors in the Indian community. The high prevalence underscores the need for gender-sensitive prevention and early screening efforts.