Are factors associated with suicidal ideation true risk factors? A 3-year prospective follow-up study in a general population.
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.
Hintikka
Jukka
J
Department of Psychiatry, Kuopio University Hospital, 70211, Kuopio, Finland.
Koivumaa-Honkanen
Heli
H
Lehto
Soili Marianne
SM
Tolmunen
Tommi
T
Honkalampi
Kirsi
K
Haatainen
Kaisa
K
Viinamäki
Heimo
H
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
D000928:Antidepressive Agents