Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-26T12:12:39.199Z Has data issue: false hasContentIssue false
  • English
  • Français

Youth suicide attempts and the dose–response relationship to parental risk factors: a population-based study

Published online by Cambridge University Press:  21 April 2010

E. Christiansen ,
R. D. Goldney ,
A. L. Beautrai  and
E. Agerbo
E. Christiansen*
Affiliation:
Clinic of Suicide Prevention, Department of Child and Adolescent Psychiatry, Odense University Hospital, Denmark
R. D. Goldney
Affiliation:
Discipline of Psychiatry, University of Adelaide, South Australia
A. L. Beautrai
Affiliation:
Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
E. Agerbo
Affiliation:
National Centre for Register-Based Research, University of Aarhus, Denmark
*
*Address for correspondence: E. Christiansen, M.Sc., Clinic of Suicide Prevention, Department of Child and Adolescent Psychiatry, Odense University Hospital, Bjergegade 15, 1 sal, DK-5000 Odense C, Denmark. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There is a lack of specific knowledge about the dose–response effect of multiple parental risk factors for suicide attempts among children and adolescents. The aim of this study was to determine the dose–response effect of multiple parental risk factors on an offspring's risk for suicide attempt.

Method

We designed a population-based two-generation nested case–control study and used Danish register data. A population of 403 431 individuals born between 1983 and 1989 was sampled. Among these, 3465 (0.8%) were registered as having had a suicide attempt. Twenty controls were matched to each case and a link to the offspring's biological parents was established.

Results

There was a dose–response relationship between the number of exposures and the risk of suicide attempts, with the increased risk seeming to be a multiplicative effect. Parental suicide, suicide attempt, psychiatric illness and low level of income were all significant independent risk factors for offspring's suicide attempts.

Conclusions

Knowledge of the effect of multiple risk factors on the likelihood of suicide attempts in children and adolescents is important for risk assessment. Dose–response effects of multiple parental risk factors are multiplicative, but it is rare for children and adolescents to be exposed to multiple parental risk factors simultaneously. Nevertheless, they should be considered along with the offspring's own multiple risk factors in determining the overall risk of a suicide attempt. Further research incorporating both parental and offspring's risk factors is indicated to determine the overall dose–response effect of multiple risk factors.

Keywords

Dose–responseyouth suicide attemptsparental risk factors
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 2 , February 2011 , pp. 313 - 319
Copyright
Copyright © Cambridge University Press 2010

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

Agerbo, E, Nordentoft, M, Mortensen, PB (2002). Familial, psychiatric, and socioeconomic risk factors for suicide in young people: nested case-control study. British Medical Journal 325, 74–78.CrossRefGoogle ScholarPubMed
Andersen, TF, Madsen, M, Jorgensen, J, Mellemkjoer, L, Olsen, JH (1999). The Danish National Hospital Register. A valuable source of data for modern health sciences. Danish Medical Bulletin 46, 263–268.Google Scholar
Beautrais, A (1996). Serious Suicide Attempts in Young People: A Case Control Study. Ph.D. thesis, University of Otago, New Zealand.Google Scholar
Beautrais, AL, Joyce, PR, Mulder, RT, Fergusson, DM, Deavoll, BJ, Nightingale, SK (1996). Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study. American Journal of Psychiatry 153, 1009–1014.Google ScholarPubMed
Bille-Brahe, U, Schmidtke, A, Kerkhof, AJ, De Leo, D, Lonnqvist, J, Platt, S, Sampaio Faria, J (1995). Background and introduction to the WHO/EURO Multicentre Study on Parasuicide. Crisis 16, 72–78.CrossRefGoogle Scholar
Breslow, NE, Lubin, JH, Marek, P, Langholz, B (1983). Multiplicative models and cohort analysis. Journal of the American Statistical Association 78, 1–12.CrossRefGoogle Scholar
Bruzzi, P, Green, SB, Byar, DP, Brinton, LA, Schairer, C (1985). Estimating the population attributable risk for multiple risk factors using case-control data. American Journal of Epidemiology 122, 904–914.CrossRefGoogle ScholarPubMed
Centre for Suicide Research (2010). (www.selvmordsforskning.dk). Accessed February 2010.Google Scholar
Fergusson, DM, Woodward, LJ, Horwood, LJ (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
Goldney, RD (2008). Suicide Prevention. Oxford University Press: Oxford.CrossRefGoogle Scholar
Johnson, BA, Brent, DA, Bridge, J, Connolly, J (1998). The familial aggregation of adolescent suicide attempts. Acta Psychiatrica Scandinavica 97, 18–24.CrossRefGoogle ScholarPubMed
King, G, Zeng, L (2002). Estimating risk and rate levels, ratios and differences in case-control studies. Statistics in Medicine 21, 1409–1427.CrossRefGoogle ScholarPubMed
Knudsen, LB (1998). The Danish Fertility Database. Danish Medical Bulletin 45, 221–225.Google ScholarPubMed
Mittendorfer-Rutz, E, Rasmussen, F, Wasserman, D (2008). Familial clustering of suicidal behaviour and psychopathology in young suicide attempters. A register-based nested case control study. Social Psychiatry and Psychiatric Epidemiology 43, 28–36.CrossRefGoogle ScholarPubMed
Mortensen, PB, Agerbo, E, Erikson, T, Qin, P, Westergaard-Nielsen, N (2000). Psychiatric illness and risk factors for suicide in Denmark. Lancet 355, 9–12.CrossRefGoogle ScholarPubMed
Munk-Jørgensen, P, Mortensen, PB (1997). The Danish Psychiatric Central Register. Danish Medical Bulletin 44, 82–84.Google ScholarPubMed
Nordentoft, M (2007). Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Danish Medical Bulletin 54, 306–369.Google ScholarPubMed
Nordentoft, M, Søgaard, M (2005). Registration, psychiatric evaluation, and adherence to psychiatric treatment after suicide attempt. Nordic Journal of Psychiatry 59, 213–216.CrossRefGoogle ScholarPubMed
Pedersen, CB, Gotzsche, H, Moller, JO, Mortensen, PB (2006). The Danish Civil Registration System. A cohort of eight million persons. Danish Medical Bulletin 53, 441–449.Google ScholarPubMed
Qin, P, Agerbo, E, Mortensen, PB (2003). Suicide risk in relation to socio-economic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981–1997. American Journal of Psychiatry 160, 765–772.CrossRefGoogle Scholar
Sørensen, HJ, Mortensen, EL, Wang, AG, Juel, K, Silverton, L, Mednick, SA (2009). Suicide and mental illness in parents and risk of suicide in offspring: a birth cohort study. Social Psychiatry and Psychiatric Epidemiology 44, 748–751.CrossRefGoogle ScholarPubMed
The Danish National Board of Health (1992). Cause of Death in Denmark 1990 [in Danish]. Sundhedsstyrelsen: Copenhagen.Google Scholar