The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student Initiative
Por:
Mortier P, Yang X, Altwaijri YA, Holdcraft JA, Lee S, Sampson NA, Albor Y, Alhadi AN, Alonso J, Al-Saud NK, Andersson C, Atwoli L, Auerbach RP, Muaka CA, Báez-Mansur PM, Ballester L, Bantjes J, Baumeister H, Bendtsen M, Benjet C, Berman AH, Bruffaerts R, Carrasco P, Chan SCN, Cohut I, Covarrubias Díaz Couder MA, Crockett MA, Cuijpers P, David OA, Dong D, Ebert DD, Gaete J, Félez M, García Forero C, Gili M, Gutiérrez-García RA, Haro JM, Hasking P, Hunt X, Husky MM, Jaguga F, Jansen L, Langer ÁI, Liu Y, Mac-Ginty S, Martínez V, Mason A, Mathai M, McLafferty M, Miranda AE, Murray EK, Musyoka CM, O'Neill SM, Papasteri CC, Piqueras JA, Popescu CA, Rapsey C, Robinson K, Rodriguez-Jimenez T, Scarf D, Siu OL, Stein DJ, Struijs SY, Tomoiaga CT, Valdés-García KP, Vereecke S, Vigo DV, Wang AY, Wong SYS and Kessler RC
Publicada:
1 ago 2025
Ahead of Print:
1 may 2025
Resumen:
Objective: To investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students. Method: Poisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes. Results: Lifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4-7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5-7.7]), followed by MDx (RR range 1.3-3.0). Of the demographic subgroups, trans-gender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3-2.6]; ideation-to-attempt transition RR=1.5 [1.3-1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9-2.2]), major depressive disorder (RR=2.0 [1.9-2.1]), and bipolar disorder (RR=1.8 [1.6-2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3-1.7]), bi-polar disorder (RR=1.4 [1.2-1.7]), and sexual abuse (RR=1.4 [1.2-1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0-1.8]). Conclusion: CAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.
Filiaciones:
Mortier P:
Health Services Research Group, Hospital del Mar Research Institute, Carrer del Doctor Aiguader, 88 08003 Barcelona, Spain
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
Yang X:
The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China
Altwaijri YA:
Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Holdcraft JA:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Lee S:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Sampson NA:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Albor Y:
Center for Global Mental Health Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
Alhadi AN:
Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
SABIC Psychological Health Research & Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Alonso J:
Health Services Research Group, Hospital del Mar Research Institute, Carrer del Doctor Aiguader, 88 08003 Barcelona, Spain
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
Department of Medicine and Life Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
Al-Saud NK:
Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Andersson C:
Department of Criminology, Malmö University, Malmö, Sweden
Atwoli L:
Department of Medicine, Medical College East Africa, the Aga Khan University, Nairobi, Kenya
Brain and Mind Institute, the Aga Khan University, Nairobi, Kenya
Department of Mental Health and Behavioural Sciences, Moi University School of Medicine, Eldoret, Kenya
Auerbach RP:
Department of Psychiatry, Columbia University, New York, NY, USA
Muaka CA:
Department of Psychology & Counselling, Daystar University, Nairobi, Kenya
Báez-Mansur PM:
Coordinación de Desarrollo Académico y Servicios Educativos, Universidad la Salle Ciudad Victoria, Ciudad Victoria, Mexico
Ballester L:
Health Services Research Group, Hospital del Mar Research Institute, Carrer del Doctor Aiguader, 88 08003 Barcelona, Spain
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
Bantjes J:
Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
Department of Psychiatry and Mental Health, University of Cape Town, South Africa
Institute for Life Course Health Research, Global Health, Stellenbosch University
Baumeister H:
Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
Bendtsen M:
Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
Benjet C:
Center for Global Mental Health Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
Berman AH:
Department of Psychology, Uppsala University, Uppsala, Sweden
Bruffaerts R:
Center for Public Health Psychiatry, Department of Neurosciences, Katholieke Universiteit Leuven (KUL), Leuven, Belgium
Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium
WHO Collaborating Centre for Public Health Psychiatry, KU Leuven, Belgium
Carrasco P:
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
Department of Medicine, Universitat Jaume I, Castellón de la Plana, Spain
Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
Chan SCN:
The Hong Kong University of Science and Technology, Hong Kong SAR, PR China
Cohut I:
Career Counseling and Guidance Center, Technical University of Cluj-Napoca, Romania
Covarrubias Díaz Couder MA:
Coordinación de Investigación, Universidad La Salle Noroeste
Crockett MA:
Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
Cuijpers P:
Faculty of Behavioural and Movement Science, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
David OA:
DATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babe?-Bolyai University, Cluj-Napoca, Romania
Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
Dong D:
The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China
Ebert DD:
School of Medicine and Health, Department for Sport and Health Sciences, Technical University Munich, Germany
Gaete J:
Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
Centro de Investigación en Salud Mental Estudiantil (ISME), Facultad de Ciencias Sociales, Universidad de los Andes, Santiago, Chile
Félez M:
Parc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat , Barcelona, Spain
García Forero C:
Departamento de Medicina, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
Gili M:
Department of Psychology, University of the Balearic Islands (UIB), Palma, Mallorca, Spain
Gutiérrez-García RA:
Universidad La Salle Bajío, campus Salamanca, Mexico
Haro JM:
Parc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat , Barcelona, Spain
Centro de investigación Biomédica en Red en Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Hasking P:
School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
Curtin enAble Institute, Curtin University, Perth, Australia
Hunt X:
Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
Africa Health Research Institute (AHRI), Durban, South Africa
Husky MM:
Active Team, Bordeaux Population Health Research Center, INSERM U1219, University of Bordeaux, France
Jaguga F:
Department of Alcohol and Drug Abuse Rehabilitation Services, Moi Teaching and Referral Hospital, Eldoret, Kenya
Jansen L:
Center for Public Health Psychiatry, Department of Neurosciences, Katholieke Universiteit Leuven (KUL), Leuven, Belgium
Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium
Langer ÁI:
Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
Facultad de Psicología y Humanidades, Universidad San Sebastián, Santiago, Chile
Liu Y:
School of Public Health, Jining Medical University, Jining 272067, Shandong Province, PR China
Mac-Ginty S:
Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
Department of Health Service & Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Martínez V:
Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (Cemera), Facultad de Medicina, Universidad de Chile, Santiago, Chile
Mason A:
School of Psychological and Social Sciences, University of Waikato, Hamilton, New Zealand
Mathai M:
Department of Psychiatry, Faculty of Health Sciences, University of Nairobi, Kenya
McLafferty M:
Personalised Medicine Centre, School of Medicine, Ulster University, Derry/Londonderry, UK
Atlantic Technological University, Donegal, Ireland
Miranda AE:
Centro de investigación Biomédica en Red en Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Sant Joan de Déu Research Institute, Carrer de Santa Rosa, 39-57, 08950, Esplugues del Llobregat, Spain
Murray EK:
Personalised Medicine Centre, School of Medicine, Ulster University, Derry/Londonderry, UK
Musyoka CM:
Department of Psychiatry, Faculty of Health Sciences, University of Nairobi, Kenya
O'Neill SM:
School of Psychology, Ulster University, Coleraine, UK
Papasteri CC:
Department of Psychology and Cognitive Sciences, University of Bucharest, Romania
Piqueras JA:
Department of Health Psychology, Universidad Miguel Hernandez de Elche (UMH), Alicante, Spain
Popescu CA:
Department of Human Sciences, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
Rapsey C:
Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
Robinson K:
School of Psychology, Massey University, Wellington, New Zealand
Rodriguez-Jimenez T:
Department of Psychology and Sociology, Universidad de Zaragoza (UNIZAR), Zaragoza, Spain
Scarf D:
Department of Psychology, University of Otago, Dunedin, New Zealand
Siu OL:
Department of Psychology, Lingnan University, Hong Kong, SAR, China
Stein DJ:
SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
Struijs SY:
Faculty of Behavioural and Movement Science, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
Tomoiaga CT:
DATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babe?-Bolyai University, Cluj-Napoca, Romania
Valdés-García KP:
Facultad de Psicología, Universidad Autónoma de Coahuila, Saltillo, Mexico
Vereecke S:
Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Vigo DV:
Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Wang AY:
Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Wong SYS:
The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China
Kessler RC:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Green Submitted, hybrid
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