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Trajectories of suicide attempts from early adolescence to emerging adulthood: prospective 11-year follow-up of a Canadian cohort

Published online by Cambridge University Press:  15 April 2020

Marie-Claude Geoffroy Open the ORCID record for Marie-Claude Geoffroy [Opens in a new window] ,
Massimiliano Orri ,
Alain Girard ,
Lea C. Perret  and
Gustavo Turecki
Marie-Claude Geoffroy*
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
Massimiliano Orri
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada Bordeaux Population Health Research Center, University of Bordeaux, INSERM U1219, France
Alain Girard
Affiliation:
Research Unit on Children's Psychosocial Maladjustment, University of Montrea
Lea C. Perret
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
Gustavo Turecki
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
*
Author for correspondence: Marie-Claude Geoffroy, E-mail: [email protected]
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Abstract

Background

Suicide is a leading cause of mortality in youth, yet the course of suicide attempts is poorly documented. We explored the vulnerable transition from adolescence to emerging adulthood to identify group trajectories and risk factors.

Methods

The National Longitudinal Survey of Children and Youth is a prospective representative cohort of Canadian children. We followed participants aged 7–11 years in 1994–95 to age 23 (2008–09). We modelled self-reported past-year suicide attempts (ages 12 to 23 years) using growth mixture models. We analysed risk factors from self- and parent-report questionnaires at pre-adolescence (ages 10–11) and early adolescence (ages 12–13) using multinomial logistic regressions. Analyses were adjusted for sample non-response and attrition.

Results

In 2233 participants answering questions on teen and adult suicide attempts, we identified three trajectories: never attempted (96.0%), adolescence-limited (2.0%) and persisting into adulthood (2.0%). Adolescent girls aged 12–13 with depression/anxiety symptoms, and with mothers experiencing depression had higher risks of adolescence-limited than never-attempted [relative risk RR 9.27 (95% confidence interval: 1.73–49.82); 2.03 (1.02–3.32), for each standard deviation increase; 1.07 (1.00–1.15); respectively]. Preteen ADHD symptoms increased the risk of attempts persisting into adulthood as compared to never-attempted [RR 2.05 (1.29–3.28) for each standard deviation increase]. Suicide death of schoolmate/acquaintance increased risks of an adulthood trajectory as compared to never-attempted and adolescence-limited [RR 8.41 (3.04–23.27) and 6.63 (1.29–34.06), respectively].

Conclusion

In half the participants attempting suicide, attempts continued into adulthood. We stress the need for preventive strategies in early adolescence and differential clinical/educational interventions as identified for each trajectory.

Keywords

Adolescencedevelopmentepidemiologylongitudinal studysuicide attempt
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 11 , August 2021 , pp. 1933 - 1943
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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