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Identifying correlates of suicide attempts in suicidal ideators: a population-based study

Published online by Cambridge University Press:  31 May 2007

JELENA BREZO ,
JOEL PARIS ,
RICHARD TREMBLAY ,
FRANK VITARO ,
MARTINE HÉBERT  and
GUSTAVO TURECKI
JELENA BREZO
Affiliation:
McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal, Canada
JOEL PARIS
Affiliation:
Department of Psychiatry, McGill University, Montreal, Canada
RICHARD TREMBLAY
Affiliation:
GRIP, University of Montreal, Montreal, Canada
FRANK VITARO
Affiliation:
GRIP, University of Montreal, Montreal, Canada
MARTINE HÉBERT
Affiliation:
Department of Sexology, University of Quebec, Montreal, Canada
GUSTAVO TURECKI*
Affiliation:
McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal, Canada Department of Psychiatry, McGill University, Montreal, Canada
*
*Address for correspondence: Gustavo Turecki, M.D., Ph.D., McGill Group for Suicide Studies, Douglas Hospital, McGill University, 6875 LaSalle blvd, Montreal, QC H4H 1R3, Canada. (Email: [email protected])
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Abstract

Background

Identification of factors that distinguish between ideators who act on their suicidal thoughts from those who do not is an important clinical and research objective.

Method

We examined correlates of suicide attempts in suicidal ideators, members of a French-Canadian, school-based cohort. Suicidal thoughts were evaluated in adolescence and early adulthood in the total sample of suicidal ideators, who were then stratified into subgroups consisting of persistent ideators, male ideators and female ideators.

Results

In addition to persistent suicidal ideas [odds ratios (ORs) 2·1–2·8], Axis I psychopathology, female gender and childhood sexual abuse (CSA) were the most consistent correlates of suicide attempts. Externalizing disorders were significant contributors in persistent ideators [drug misuse: OR 2·8, 95% confidence interval (CI) 1·1–6·9] and in male ideators in particular (disruptive disorders: OR 5·9, 95% CI 2·2–16·0). In women, psychiatric co-morbidity also had a significant effect (OR 1·6, 95% CI 1·1–2·1). CSA was of relevance in both women (OR 1·2, 95% CI 1·1–1·4) and persistent ideators (OR 1·3, 95% CI 1·1–1·5). Personality traits showed gender-specific contribution with affective instability (OR 1·1, 95% CI 1·01–1·1) and anxiousness (OR 1·3, 95% CI 1·1–1·7) contributing in men and disruptive aggression (OR 1·1, 95% CI 1·03–1·3) in women.

Conclusions

Correlates of suicide attempts in suicidal ideators vary as a function of the persistence of suicidal ideas and gender. This heterogeneity across subgroups of suicidal ideators may be attributed, at least in part, to differences between the sexes, early environmental adversity, maladaptive personality, and psychiatric symptoms. Further exploration and continued prospective follow-up is necessary to examine these possibilities.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 11 , November 2007 , pp. 1551 - 1562
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

Barratt, E. (1985). Impulsive subtraits: arousal and information processing. In Motivation, Emotion, and Personality (ed. Spence, J. T. and Izard, C. E.), pp. 137–146. Elsevier: New York.Google Scholar
Beautrais, A. L. (2000). Risk factors for suicide and attempted suicide among young people. The Australian and New Zealand Journal of Psychiatry 34, 420–436.CrossRefGoogle ScholarPubMed
Beautrais, A. L., Joyce, P. R. & Mulder, R. T. (1999). Cannabis abuse and serious suicide attempts. Addiction 94, 1155–1164.CrossRefGoogle ScholarPubMed
Beautrais, A. L., Wells, J. E., McGee, M. A. & Oakley Browne, M. A. (2006). Suicidal behaviour in Te Rau Hinengaro: the New Zealand Mental Health Survey. The Australian and New Zealand Journal of Psychiatry 40, 896–904.CrossRefGoogle ScholarPubMed
Beck, A. T., Kovacs, M. & Weissman, A. (1979). Assessment of suicidal intention: the scale of suicidal ideation. Journal of Clinical and Consulting Psychology 47, 343–352.CrossRefGoogle Scholar
Beck, A. T., Schuyler, D. & Herman, I. (1974). Development of suicide intent scales. In The Prediction of Suicide (ed. Beck, A. T., Resnik, H. L. P. and Lettier, D. J.), pp. 45–56. The Charles Press: Philadelphia.Google Scholar
Beck, A. T. & Steer, R. A. (1989). Clinical predictors of eventual suicide: a 5- to 10-year prospective study of suicide attempters. Journal of Affective Disorders 17, 203–209.CrossRefGoogle ScholarPubMed
Boden, J. M., Fergusson, D. M. & John Horwood, L. (2007). Anxiety disorders and suicidal behaviours in adolescence and young adulthood: findings from a longitudinal study. Psychological Medicine 37, 431–440.CrossRefGoogle Scholar
Bowlby, J. (1989). The Role of Attachment in Personality Development and Psychopathology. International Universities Press, Inc: Madison, CT.Google Scholar
Brent, D. A., Perper, J. A., Moritz, G., Allman, C., Friend, A., Roth, C., Schweers, J., Balach, L. & Baugher, M. (1993). Psychiatric risk factors for adolescent suicide: a case-control study. Journal of the American Academy of Child and Adolescent Psychiatry 32, 521–529.CrossRefGoogle ScholarPubMed
Breton, J. J., Bergeron, L., Valla, J. P., Berthiaume, C. & St-Georges, M. (1998). Diagnostic interview schedule for children (DISC-2.25) in Quebec: reliability findings in light of the MECA study. Journal of the American Academy of Child and Adolescent Psychiatry 32, 521–529.Google Scholar
Brezo, J., Paris, J., Tremblay, R., Vitaro, F., Zoccolillo, M., Hebert, M. & Turecki, G. (2006 a). Personality traits as correlates of suicide attempts and suicidal ideation in young adults. Psychological Medicine 36, 191–202.CrossRefGoogle ScholarPubMed
Brezo, J., Paris, J. & Turecki, G. (2006 b). Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: a systematic review. Acta Psychiatrica Scandinavica 113, 180–206.CrossRefGoogle ScholarPubMed
Caspi, A., Moffitt, T. E., Newman, D. L. & Silva, P. A. (1996). Behavioral observations at age 3 years predict adult psychiatric disorders. Longitudinal evidence from a birth cohort. Archives of General Psychiatry 53, 1033–1039.CrossRefGoogle ScholarPubMed
D'Eramo, K. S., Prinstein, M. J., Freeman, J., Grapentine, W. L. & Spirito, A. (2004). Psychiatric diagnoses and comorbidity in relation to suicidal behavior among psychiatrically hospitalized adolescents. Child Psychiatry and Human Development 35, 21–35.CrossRefGoogle ScholarPubMed
De Leo, D., Cerin, E., Spathonis, K. & Burgis, S. (2005). Lifetime risk of suicide ideation and attempts in an Australian community: prevalence, suicidal process, and help-seeking behaviour. Journal of Affective Disorders 86, 215–224.CrossRefGoogle Scholar
Dean, P. J. & Range, L. M. (1996). The escape theory of suicide and perfectionism in college students. Death Studies 20, 415–424.CrossRefGoogle ScholarPubMed
Dhossche, D., Ferdinand, R., van der Ende, J., Hofstra, M. B. & Verhulst, F. (2002). Diagnostic outcome of adolescent self-reported suicidal ideation at 8-year follow-up. Journal of Affective Disorders 72, 273–279.CrossRefGoogle ScholarPubMed
Duberstein, P. R., Conwell, Y., Seidlitz, L., Denning, D. G., Cox, C. & Caine, E. D. (2000). Personality traits and suicidal behavior and ideation in depressed inpatients 50 years of age and older. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 55, P18–P26.Google ScholarPubMed
Fairweather, A. K., Anstey, K. J., Rodgers, B. & Butterworth, P. (2006). Factors distinguishing suicide attempters from suicide ideators in a community sample: social issues and physical health problems. Psychological Medicine 36, 1235–1245.CrossRefGoogle Scholar
Feingold, A. (1994). Gender differences in personality: a meta-analysis. Psychological Bulletin 116, 429–456.CrossRefGoogle ScholarPubMed
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P. & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine 14, 245–258.CrossRefGoogle ScholarPubMed
Fergusson, D. M., Woodward, L. J. & Horwood, L. J. (2000). Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychological Medicine 30, 23–39.CrossRefGoogle ScholarPubMed
Gladstone, G. L., Parker, G. B., Mitchell, P. B., Malhi, G. S., Wilhelm, K. & Austin, M. P. (2004). Implications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization. American Journal of Psychiatry 161, 1417–1425.CrossRefGoogle ScholarPubMed
Gould, M. S., King, R., Greenwald, S., Fisher, P., Schwab-Stone, M., Kramer, R., Flisher, A. J., Goodman, S., Canino, G. & Shaffer, D. (1998). Psychopathology associated with suicidal ideation and attempts among children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 37, 915–923.CrossRefGoogle ScholarPubMed
Gutierrez, P. M., Thakkar, R. R. & Kuczen, C. (2000). Exploration of the relationship between physical and/or sexual abuse, attitudes about life and death, and suicidal ideation in young women. Death Studies 24, 675–688.Google ScholarPubMed
Horney, J. (2001). Crime and the criminal events perspective. In The Process and Structure of Crime: Criminal Events and Crime Analysis (ed. Meier, R. F., Kennedy, L. W. and Sacco, V. F.), pp. 141–167. Transaction Publishing: New Brunswick, NJ.Google Scholar
Hosmer, D. W. & Lemeshow, S. (2000). Applied Logistic Regression. Wiley & Sons: New York.CrossRefGoogle Scholar
Kelly, T. M., Cornelius, J. R. & Clark, D. B. (2004). Psychiatric disorders and attempted suicide among adolescents with substance use disorders. Drug and Alcohol Dependence 73, 87–97.CrossRefGoogle ScholarPubMed
Kelly, T. M., Cornelius, J. R. & Lynch, K. G. (2002). Psychiatric and substance use disorders as risk factors for attempted suicide among adolescents: a case control study. Suicide and Life-Threatening Behavior 32, 301–312.CrossRefGoogle ScholarPubMed
Kessler, R. C., Borges, G. & Walters, E. E. (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry 56, 617–626.CrossRefGoogle ScholarPubMed
King, R. A., Schwab-Stone, M., Flisher, A. J., Greenwald, S., Kramer, R. A., Goodman, S. H., Lahey, B. B., Shaffer, D. & Gould, M. S. (2001). Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry 40, 837–846.CrossRefGoogle ScholarPubMed
Kirmayer, L. J., Boothroyd, L. J. & Hodgins, S. (1998). Attempted suicide among Inuit youth: psychosocial correlates and implications for prevention. Canadian Journal of Psychiatry 43, 816–822.CrossRefGoogle ScholarPubMed
Lewinsohn, P. M., Gotlib, I. H. and Seeley, J. R. (1995). Adolescent psychopathology: IV. Specificity of psychosocial risk factors for depression and substance abuse in older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 34, 1221–1229.CrossRefGoogle ScholarPubMed
Lewinsohn, P. M., Rohde, P. & Seeley, J. R. (1993). Psychosocial characteristics of adolescents with a history of suicide attempt. Journal of the American Academy of Child and Adolescent Psychiatry 32, 60–68.CrossRefGoogle ScholarPubMed
Lewinsohn, P. M., Rohde, P. & Seeley, J. R. (1996). Adolescent suicidal ideation and attempts: prevalence, risk factors, and clinical implications. Clinical Psychology: Science and Practice 3, 25–46.Google Scholar
Livesley, W. J., Jang, K. L. & Vernon, P. A. (1998). Phenotypic and genetic structure of traits delineating personality disorder. Archives of General Psychiatry 55, 941–948.CrossRefGoogle ScholarPubMed
Malinovsky-Rummell, R. & Hansen, D. J. (1993). Long-term consequences of childhood physical abuse. Psychological Bulletin 114, 68–79.CrossRefGoogle Scholar
Mann, J. J. (2002). A current perspective of suicide and attempted suicide. Annals of Internal Medicine 136, 302–311.CrossRefGoogle ScholarPubMed
Martinez-Aran, A., Vieta, E., Reinares, M., Colom, F., Torrent, C., Sanchez-Moreno, J., Benabarre, A., Goikolea, J. M., Comes, M. & Salamero, M. (2004). Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry 161, 262–270.CrossRefGoogle ScholarPubMed
Masse, L. C. & Tremblay, R. E. (1997). Behavior of boys in kindergarten and the onset of substance use during adolescence. Archives of General Psychiatry 54, 62–68.CrossRefGoogle Scholar
McClellan, J., McCurry, C., Ronnei, M., Adams, J., Storck, M., Eisner, A. & Smith, C. (1997). Relationship between sexual abuse, gender, and sexually inappropriate behaviors in seriously mentally ill youths. Journal of the American Academy of Child and Adolescent Psychiatry 36, 959–965.CrossRefGoogle ScholarPubMed
O'Boyle, M. & Brandon, E. A. (1998). Suicide attempts, substance abuse, and personality. Journal of Substance Abuse Treatment 15, 353–356.CrossRefGoogle ScholarPubMed
Pirkis, J., Burgess, P. & Dunt, D. (2000). Suicidal ideation and suicide attempts among Australian adults. Crisis 21, 16–25.CrossRefGoogle ScholarPubMed
Renaud, J., Brent, D. A., Birmaher, B., Chiappetta, L. & Bridge, J. (1999). Suicide in adolescents with disruptive disorders. Journal of the Academy of Child and Adolescent Psychiatry 38, 846–851.CrossRefGoogle ScholarPubMed
Robins, L. N., Cottler, L. B., Bucholtz, K. & Compton, W. (1995). Diagnostic Interview Schedule for DSM-IV. Washington University: St Louis, MO.Google Scholar
Rudd, M. D., Joiner, T. & Rajab, M. H. (1996). Relationships among suicide ideators, attempters, and multiple attempters in a young-adult sample. Journal of Abnormal Psychology 105, 541–550.CrossRefGoogle Scholar
Santa Mina, E. E. & Gallop, R. M. (1998). Childhood sexual and physical abuse and adult self-harm and suicidal behaviour: a literature review. Canadian Journal of Psychiatry 43, 793–800.CrossRefGoogle ScholarPubMed
Statham, D. J., Heath, A. C., Madden, P. A., Bucholz, K. K., Bierut, L., Dinwiddie, S. H., Slutske, W. S., Dunne, M. P. & Martin, N. G. (1998). Suicidal behaviour: an epidemiological and genetic study. Psychological Medicine 28, 839–855.CrossRefGoogle ScholarPubMed
Straus, M. A., Hamby, S. L., Boney-McCoy, S. & Sugarman, D. B. (1996). The revised conflict tactics scales (CTS2). Development and preliminary psychometric data. Journal of Family Issues 17, 283–316.CrossRefGoogle Scholar
Suokas, J., Suominen, K., Isometsa, E., Ostamo, A. & Lonnqvist, J. (2001). Long-term risk factors for suicide mortality after attempted suicide – findings of a 14-year follow-up study. Acta Psychiatrica Scandinavica 104, 117–121.CrossRefGoogle ScholarPubMed
Talbot, N. L., Duberstein, P. R., Cox, C., Denning, D. & Conwell, Y. (2004). Preliminary report on childhood sexual abuse, suicidal ideation, and suicide attempts among middle-aged and older depressed women. American Journal of Geriatric Psychiatry 12, 536–538.CrossRefGoogle ScholarPubMed
Thompson, M. P., Kingree, J. B. & Desai, S. (2004). Gender differences in long-term health consequences of physical abuse of children: data from a nationally representative survey. American Journal of Public Health 94, 599–604.CrossRefGoogle ScholarPubMed
Tournier, M., Molimard, M., Cougnard, A., Abouelfath, A., Fourrier, A. & Verdoux, H. (2005). Psychiatric disorders and their comorbidity in subjects with parasuicide by intentional drug overdose: prevalence and gender differences. Psychiatry Research 136, 93–100.CrossRefGoogle ScholarPubMed
Turner, R. J. (1983). Social support: conceptualization, measurement, and implications for mental health. Research in Community and Mental Health 3, 67–111.Google Scholar
van Heeringen, K. (1994). Epidemiological aspects of attempted suicide – a case-control study in Gent, Belgium. Crisis 15, 115–122.Google ScholarPubMed
Wagner, K. D., Rouleau, M. & Joiner, T. (2000). Cognitive factors related to suicidal ideation and resolution in psychiatrically hospitalized children and adolescents. American Journal of Psychiatry 157, 2017–2021.CrossRefGoogle ScholarPubMed
Wichstrom, L. (2000). Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 39, 603–610.CrossRefGoogle ScholarPubMed
Williams, J. & Pollock, L. (2001). Psychological aspects of the suicidal process. In Understanding Suicidal Behaviour: The Suicidal Process Approach to Research, Treatment, and Prevention (ed. van Heeringen, K.), pp. 76–94. Wiley: Chichester.Google Scholar