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Natural history of suicidal behaviors in a population-based sample of young adults

Published online by Cambridge University Press:  02 May 2007

JELENA BREZO ,
JOEL PARIS ,
EDWARD DYLAN BARKER ,
RICHARD TREMBLAY ,
FRANK VITARO ,
MARK ZOCCOLILLO ,
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
EDWARD DYLAN BARKER
Affiliation:
GRIP, University of Montreal, Montreal, Canada
RICHARD TREMBLAY
Affiliation:
GRIP, University of Montreal, Montreal, Canada
FRANK VITARO
Affiliation:
GRIP, University of Montreal, Montreal, Canada
MARK ZOCCOLILLO
Affiliation:
Montreal Children's Hospital, McGill University, 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: Dr Gustavo Turecki, 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

Suicidal behaviors in young individuals represent an important public health problem. Understanding their natural history and relationships would therefore be of clinical and research value. In this study, we examined the natural histories of several suicidal behaviors and investigated two conceptual models of suicidality (dimensional and categorical) in the context of adolescent and adult-onset suicide attempts.

Method

Participants were members of a prospectively studied, representative, population-based school cohort followed since age 6 (n=3017) through mid-adolescence (n=1715) to their early twenties (n=1684). Outcome measures included suicidal ideation, attempts and completions.

Results

Approximately one in 500 individuals died by suicide. About 33% had suicidal ideas and 9·3% made at least one suicide attempt. Over half (4·9%) of the self-reported attempters made their first attempt before age 18. With the exception of current suicidal ideas, non-fatal suicidal behaviors were more prevalent in females. In general, parental and cross-sectional self-reports underestimated suicidality rates. Aikaike (AIC) and Bayesian (BIC) information criteria suggested the ordinal model, and dimensional conceptualization of suicide attempts of different onset age, to be more optimal than its multinomial/categorical counterpart (ordinal: AIC 567.55, BIC 635.67; multinomial: AIC 616.59, BIC 723.83). Both models, nevertheless, identified five common factors of relevance to suicidal diathesis: gender, disruptive disorders, childhood anxiousness and abuse, and suicidal thoughts.

Conclusions

Non-fatal suicidal behaviors in adolescents and young adults are more common than suggested by cross-sectional studies and parental reports. The dimensional model may be more useful in explaining the relationship of suicide attempts of different age of onset.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 11 , November 2007 , pp. 1563 - 1574
Copyright
Copyright © Cambridge University Press 2007

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