Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T02:06:34.846Z Has data issue: false hasContentIssue false
  • English
  • Français

School performance and the risk of suicide attempts in young adults: a longitudinal population-based study

Published online by Cambridge University Press:  24 July 2013

K. Kosidou ,
C. Dalman ,
P. Fredlund ,
B. K. Lee ,
R. Galanti ,
G. Isacsson  and
C. Magnusson
K. Kosidou*
Affiliation:
Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
C. Dalman
Affiliation:
Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
P. Fredlund
Affiliation:
Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
B. K. Lee
Affiliation:
Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA
R. Galanti
Affiliation:
Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
G. Isacsson
Affiliation:
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
C. Magnusson
Affiliation:
Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
*
* Address for correspondence: Mrs K. Kosidou, Division of Public Health Epidemiology, Department of Public Health Sciences, Norrbacka, Karolinska University Hospital, 171 76 Stockholm, Sweden. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Poor school performance is strongly associated with attempted suicide, but the mechanisms underlying this association are uncertain. We examined this relationship and the extent to which it is explained by (i) adult health behaviours and (ii) social conditions. Furthermore, we examined the potential modifying role of previous suicidal thoughts in the relationship.

Method

We conducted a longitudinal cohort study of 6146 individuals aged 18–33 years, recruited in 2002 and 2006 in Stockholm and resurveyed in 2007 and 2010 respectively. We estimated the risk of reported lifetime suicide attempts at follow-up among individuals without a history of suicide attempts at baseline and in relation to compulsory school-leaving grades, controlling for possible confounders and mediators.

Results

There were 91 cases of self-reported suicide attempts during the follow-up (5-year incidence of 1.5%). ORs ranged from 3.35 [95% confidence interval (CI) 1.88–5.96] for those in the lowest grade quartile to 2.60 (95% CI 1.48–4.57) and 1.76 (95% CI 0.99–3.13) for those in the second and third quartiles respectively. The relationship between school performance and risk of suicide attempts did not differ by sex. Adult health behaviours and social conditions marginally attenuated, but did not explain, the relationship. The gradient varied with baseline history of suicidal thoughts, and was found only among individuals without such a history.

Conclusions

Poor school performance was found to predict suicide attempts among young adults without a history of suicidal thoughts. Adult health behaviours and social conditions did not explain this relationship. Instead, other factors linked with poor school performance, such as poor coping ability, may increase the risk of suicide attempts.

Keywords

Adult health behavioursadult social conditionsschool performancesuicide attemptsyoung adults
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 6 , April 2014 , pp. 1235 - 1243
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alati, R, Gunnell, D, Najman, J, Williams, G, Lawlor, D (2009). Is IQ in childhood associated with suicidal thoughts and attempts? Findings from the Mater University Study of Pregnancy and its outcomes. Suicide and Life-Threatening Behavior 39, 282–293.Google Scholar
Allebeck, P, Allgulander, C, Fisher, LD (1988). Predictors of completed suicide in a cohort of 50,465 young men: role of personality and deviant behaviour. British Medical Journal 297, 176–178.Google Scholar
Andersson, L, Allebeck, P, Gustafsson, JE, Gunnell, D (2008). Association of IQ scores and school achievement with suicide in a 40-year follow-up of a Swedish cohort. Acta Psychiatrica Scandinavica 118, 99–105.Google Scholar
Batty, GD, Deary, IJ, MacIntyre, S (2006). Childhood IQ and life course socioeconomic position in relation to alcohol induced hangovers in adulthood: the Aberdeen children of the 1950s study. Journal of Epidemiology and Community Health 60, 872–874.CrossRefGoogle ScholarPubMed
Batty, GD, Whitley, E, Deary, IJ, Gale, CR, Tynelius, P, Rasmussen, F (2010). Psychosis alters association between IQ and future risk of attempted suicide: cohort study of 1,109,475 Swedish men. British Medical Journal 340, c2506.CrossRefGoogle ScholarPubMed
Björkenstam, C, Weitoft, GR, Hjern, A, Nordström, P, Hallqvist, J, Ljung, R (2011). School grades, parental education and suicide – a national register-based cohort study. Journal of Epidemiology and Community Health 65, 993–998.CrossRefGoogle ScholarPubMed
Bratko, D, Butkovic, A, Vukasovic, T, Chamorro-Premuzic, T, von Stumm, S (2012). Cognitive ability, self-assessed intelligence and personality: common genetic but independent environmental aetiologies. Intelligence 40, 91–99.CrossRefGoogle Scholar
Breslau, N, Schultz, LR, Johnson, EO, Peterson, EL, Davis, GC (2005). Smoking and the risk of suicidal behavior: a prospective study of a community sample. Archives of General Psychiatry 62, 328–334.Google Scholar
Buchmann, J, Gierow, W, Reis, O, Haessler, F (2011). Intelligence moderates impulsivity and attention in ADHD children: an ERP study using a go/nogo paradigm. World Journal of Biological Psychiatry 12 (Suppl. 1), 35–39.CrossRefGoogle ScholarPubMed
Chamorro-Premuzic, T, Furnham, A (2004). A possible model for understanding the personality–intelligence interface. British Journal of Psychology 95, 249–264.Google Scholar
Corley, J, Gow, AJ, Starr, JM, Deary, IJ (2010). Is body mass index in old age related to cognitive abilities? The Lothian Birth Cohort 1936 Study. Psychology and Aging 25, 867–875.Google Scholar
Corley, J, Gow, AJ, Starr, JM, Deary, IJ (2012). Smoking, childhood IQ, and cognitive function in old age. Journal of Psychosomatic Research 73, 132–138.CrossRefGoogle ScholarPubMed
Covey, LS, Berlin, I, Hu, MC, Hakes, J (2012). Smoking and suicidal behaviours in a sample of US adults with low mood: a retrospective analysis of longitudinal data. BMJ Open 2, e000876.Google Scholar
de Graaf, R, Bilj, RV, Smit, F, Ravelli, A, Vollebergh, WA (2000). Psychiatric and sociodemographic predictors of attrition in a longitudinal study: the Netherlands Mental Health Survey and Incidence Study (NEMESIS). American Journal of Epidemiology 152, 1039–1047.Google Scholar
Ekbom, A (2011). The Swedish Multi-generation Register. Methods in Molecular Biology 675, 215–220.Google Scholar
Fergusson, DM, Beautrais, AL, Horwood, LJ (2003). Vulnerability and resiliency to suicidal behaviours in young people. Psychological Medicine 33, 61–73.Google Scholar
Fergusson, DM, Lynskey, MT (1996). Adolescent resiliency to family adversity. Journal of Child Psychology and Psychiatry 37, 281–292.Google Scholar
Furnham, A, Monsen, J, Ahmetoglu, G (2009). Typical intellectual engagement, Big Five personality traits, approaches to learning and cognitive ability predictors of academic performance. British Journal of Educational Psychology 79, 769–782.Google Scholar
Gale, CR, Batty, GD, Tynelius, P, Deary, IJ, Rasmussen, F (2010). Intelligence in early adulthood and subsequent hospitalization for mental disorders. Epidemiology 21, 70–77.Google Scholar
Goldberg, DP, Gater, R, Sartorius, N, Ustun, TB, Piccinelli, M, Gureje, O, Rutter, C (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine 27, 191–197.Google Scholar
Gow, AJ, Corley, J, Starr, JM, Deary, IJ (2012). Reverse causation in activity-cognitive ability associations: the Lothian Birth Cohort 1936. Psychology and Aging 27, 250–255.Google Scholar
Gravseth, HM, Mehlum, L, Bjerkedal, T, Kristensen, P (2009). Suicide in young Norwegians in a life course perspective: population-based cohort study. Journal of Epidemiology and Community Health 64, 407–412.CrossRefGoogle Scholar
Gunnell, D, Harbord, R, Singleton, N, Jenkins, R, Lewis, G (2009). Is low IQ associated with an increased risk of developing suicidal thoughts? A cohort study based on an 18-month follow-up of the national psychiatric morbidity survey. Social Psychiatry and Psychiatric Epidemiology 44, 34–38.CrossRefGoogle Scholar
Gunnell, D, Löfving, S, Gustafsson, JE, Allebeck, P (2011). School performance and risk of suicide in early adulthood: follow-up of two national cohorts of Swedish schoolchildren. Journal of Affective Disorders 131, 104–112.Google Scholar
Gunnell, D, Magnusson, PK, Rasmussen, F (2005). Low intelligence test scores in 18 year old men and risk of suicide: cohort study. British Medical Journal 330, 167–170.Google Scholar
Hemmingsson, T, Melin, B, Allebeck, P, Lundberg, I (2006). The association between cognitive ability measured at ages 18–20 and mortality during 30 years of follow-up – a prospective observational study among Swedish males born 1949–51. International Journal of Epidemiology 35, 665–670.Google Scholar
Idring, S, Rai, D, Dal, H, Dalman, C, Sturm, H, Zander, E, Lee, BK, Serlachius, E, Magnusson, C (2012). Autism spectrum disorders in the Stockholm youth cohort: design, prevalence and validity. PLoS One 7, e41280.Google Scholar
Jablonska, B, Lindberg, L, Lindblad, F, Rasmussen, F, Ostberg, V, Hjern, A (2009). School performance and hospital admissions due to self-inflicted injury: a Swedish national cohort study. International Journal of Epidemiology 38, 1334–1341.Google Scholar
Jorgensen, L, Ahlbom, A, Allebeck, P, Dalman, C (2010). The Stockholm Non-Affective Psychoses Study (SNAPS): the importance of including out-patient data in incidence studies. Acta Psychiatrica Scandinavica 121, 389–392.Google Scholar
Kessler, RC, Borges, G, Sampson, N, Miller, M, Nock, MK (2009). The association between smoking and subsequent suicide-related outcomes in the National Comorbidity Survey panel sample. Molecular Psychiatry 14, 1132–1142.Google Scholar
Li, D, Yang, X, Ge, Z, Hao, Y, Wang, Q, Liu, F, Gu, D, Huang, J (2012). Cigarette smoking and risk of completed suicide: a meta-analysis of prospective cohort studies. Journal of Psychiatric Research 46, 1257–1266.Google Scholar
Lundström, S, Särndal, CE (1999). Calibration as a standard method for treatment of nonresponse. Journal of Official Statistics 15, 305–327.Google Scholar
Meehan, PJ, Lamb, JA, Saltzman, LE, O'Carroll, PW (1992). Attempted suicide among young adults: progress toward a meaningful estimate of prevalence. American Journal of Psychiatry 149, 41–44.Google Scholar
Mortensen, EL, Sørensen, HJ, Jensen, HH, Reinisch, JM, Mednick, SA (2005). IQ and mental disorder in young men. British Journal of Psychiatry 187, 407–415.Google Scholar
National Board of Health and Welfare (2009). Quality of data and reporting procedures in the National Patient Register. Discharges from inpatient care 1964–2007 and visits to specialized outpatient care (excluding primary health care) 1997–2007 [in Swedish]. National Board of Health and Welfare: Stockholm.Google Scholar
O'Connor, RC, Rasmussen, S, Hawton, K (2012). Distinguishing adolescents who think about self-harm from those who engage in self-harm. British Journal of Psychiatry 200, 330–335.Google Scholar
Osler, M, Nybo Andersen, A-M, Nordentoft, M (2008). Impaired childhood development and suicidal behaviour in a cohort of Danish men born in 1953. Journal of Epidemiology and Community Health 62, 23–28.CrossRefGoogle Scholar
Richardson, AS, Bergen, HA, Martin, G, Roeger, L, Allison, S (2005). Perceived academic performance as an indicator of risk of attempted suicide in young adolescents. Archives of Suicide Research 9, 163–176.CrossRefGoogle ScholarPubMed
Sörberg, A, Allebeck, P, Melin, B, Gunnell, D, Hemmingsson, T (2013). Cognitive ability in early adulthood is associated with later suicide and suicide attempt: the role of risk factors over the life course. Psychological Medicine 43, 49–60.CrossRefGoogle ScholarPubMed
Stavrakakis, N, de Jonge, P, Ormel, J, Oldehinkel, AJ (2012). Bidirectional prospective associations between physical activity and depressive symptoms. The TRAILS Study. Journal of Adolescent Health 50, 503–508.Google Scholar
Svensson, AC, Fredlund, P, Laflamme, L, Hallqvist, J, Alfredsson, L, Ekbom, A, Feychting, M, Forsberg, B, Pedersen, NL, Vågerö, D, Magnusson, C (2012). Cohort Profile: The Stockholm Public Health Cohort. International Journal of Epidemiology. Published online: 5 10 2012 . doi:10.1093/ije/dys126.Google Scholar
Torgen, M, Alfredsson, L, Koster, M, Wiktorin, C, Smith, KF, Kilbom, A (1997). Reproducibility of a questionnaire for assessment of present and past physical activities. International Archives of Occupational and Environmental Health 70, 107–118.Google Scholar
Webb, RT, Langstrom, N, Runeson, B, Lichtenstein, P, Fazel, S (2011). Violent offending and IQ level as predictors of suicide in schizophrenia: national cohort study. Schizophrenia Research 130, 143–147.Google Scholar
Zhang, J, Yan, F, Li, Y, McKeown, RE (2013). Body mass index and suicidal behaviors: a critical review of epidemiological evidence. Journal of Affective Disorders 148, 147–160.CrossRefGoogle ScholarPubMed