title: Are factors associated with suicidal ideation true risk factors? A 3-year prospective follow-up study in a general population.
abstract: BACKGROUND
  Adverse life events or the commencement of adverse lifestyles associate with suicidal ideation, but most associations only have been identified in cross-sectional studies. More information is needed about whether they are true risk factors and independently predict the development of suicidal ideation.
  
  
  METHODS
  A sample of the general population from Eastern Finland (n = 1,339) was followed-up for three-years with baseline and two follow-up assessments using postal questionnaires. The main adverse life events and changes in lifestyles were screened at baseline and on one- and three-year follow-up. The Beck Depression Inventory was used to assess the level of depression and the presence of suicidal ideation.
  
  
  RESULTS
  Suicidal ideation was common in the sample (annual incidence 4.3%). At baseline it associated with a cluster of adverse life events and lifestyles, as well as depression. Nevertheless, only the Beck Depression Inventory score on 3-year follow-up (OR 1.33, 95% CI 1.22-1.45) and the onset of daily smoking during the follow-up period (OR 5.38, 95% CI 1.41-20.62) independently predicted the presence of suicidal ideation on 3-year follow-up among those who had been non-suicidal at baseline and on 1-year follow-up.
  
  
  CONCLUSIONS
  Depressive mood appears to be a necessary precondition for the occurrence of suicidal ideation even after adverse life events.
authors.affiliation: Department of Psychiatry, Kuopio University Hospital, 70211, Kuopio, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Hintikka
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.forename: Soili Marianne
authors.initials: SM
authors.lastname: Lehto
authors.forename: Tommi
authors.initials: T
authors.lastname: Tolmunen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Honkalampi
authors.forename: Kaisa
authors.initials: K
authors.lastname: Haatainen
authors.forename: Heimo
authors.initials: H
authors.lastname: Viinamäki
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013405:Suicide / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents