Childhood adversities and risk for suicidal ideation and attempts: a longitudinal population-based study.
BACKGROUND
Developmental adversities may be risk factors for adult suicidal behavior, but this relationship has rarely been studied prospectively. The present study examined the association between childhood adversities and new onset suicidal ideation and attempts in an adult population-based sample.


METHODS
The study used a large community mental health survey (the Netherlands Mental Health Survey and Incidence Study; n=7076, age range 18-64 years). Logistic regression analyses were used to evaluate the relationship between childhood adversities and new onset of suicidal ideation and attempts over 3 years of longitudinal follow-up.


RESULTS
During the study period 85 new cases of suicidal ideation and 39 new onset suicide attempts were observed. The incidence rate for new suicide ideation was 0.67% per year and the incidence rate for new suicide attempts was 0.28% per year. Childhood neglect, psychological abuse and physical abuse were strongly associated with new onset suicidal ideation and suicide attempts. Odds ratios (ORs) ranged from 2.80 to 4.66 for new onset suicidal ideation and from 3.60 to 5.43 for new onset suicide attempts. The total number of adversities reported had a strong graded relationship to new onset suicidal ideation and attempts. These associations remained significant after controlling for the effects of mental disorders.


CONCLUSIONS
Childhood abuse and multiple adversities are strongly associated with future suicidal behavior and the mental disorders assessed in the present study do not fully account for this effect. A comprehensive understanding of suicidal behavior must take childhood adversities into account.
Enns
Murray W
MW
Department of Psychiatry and Community Health Sciences, University of Manitoba, Canada. menns@hsc.mb.ca
Cox
Brian J
BJ
Afifi
Tracie O
TO
De Graaf
Ron
R
Ten Have
Margreet
M
Sareen
Jitender
J
D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D013406:Suicide, Attempted / Q000706:statistics & numerical data*