Identifying correlates of suicide attempts in suicidal ideators: a population-based study.
BACKGROUND
Identification of factors that distinguish between ideators who act on their suicidal thoughts from those who do not is an important clinical and research objective.


METHODS
We examined correlates of suicide attempts in suicidal ideators, members of a French-Canadian, school-based cohort. Suicidal thoughts were evaluated in adolescence and early adulthood in the total sample of suicidal ideators, who were then stratified into subgroups consisting of persistent ideators, male ideators and female ideators.


RESULTS
In addition to persistent suicidal ideas [odds ratios (ORs) 2.1-2.8], Axis I psychopathology, female gender and childhood sexual abuse (CSA) were the most consistent correlates of suicide attempts. Externalizing disorders were significant contributors in persistent ideators [drug misuse: OR 2.8, 95% confidence interval (CI) 1.1-6.9] and in male ideators in particular (disruptive disorders: OR 5.9, 95% CI 2.2-16.0). In women, psychiatric co-morbidity also had a significant effect (OR 1.6, 95% CI 1.1-2.1). CSA was of relevance in both women (OR 1.2, 95% CI 1.1-1.4) and persistent ideators (OR 1.3, 95% CI 1.1-1.5). Personality traits showed gender-specific contribution with affective instability (OR 1.1, 95% CI 1.01-1.1) and anxiousness (OR 1.3, 95% CI 1.1-1.7) contributing in men and disruptive aggression (OR 1.1, 95% CI 1.03-1.3) in women.


CONCLUSIONS
Correlates of suicide attempts in suicidal ideators vary as a function of the persistence of suicidal ideas and gender. This heterogeneity across subgroups of suicidal ideators may be attributed, at least in part, to differences between the sexes, early environmental adversity, maladaptive personality, and psychiatric symptoms. Further exploration and continued prospective follow-up is necessary to examine these possibilities.
Brezo
Jelena
J
McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal, Canada.
Paris
Joel
J
Tremblay
Richard
R
Vitaro
Frank
F
Hébert
Martine
M
Turecki
Gustavo
G
D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008606:Mental Processes; D011599:Psychopathology; D011792:Quebec / Q000453:epidemiology; D012737:Sex Factors; D012944:Social Support; D013334:Students / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*