Understanding factors associated with death wishes and suicidal ideation (SID) may help to improve identification of subjects at risk in the general population. We assessed SID in a population-based sample of 3079 subjects, 35 to 84 years and examined multiple sex- and age-adjusted affective and bio-behavioral covariates. Anxiety and a high level of somatic complaints, particularly dyspnea, contributed to the SID risk. However, the clinical picture of subjects suffering from SID was dominated by a 6-fold adjusted increased risk of a depressive syndrome followed by impaired self perceived health (3-fold risk) in both sexes. In men, unemployment status and living alone also increased SID risk substantially. These factors open new insights for our understanding of the multifaceted etiology of suicide risks offering new strategies for early detection of subjects at risk.