Childhood predictors of completed and severe suicide attempts: findings from the Finnish 1981 Birth Cohort Study.
BACKGROUND
To our knowledge, no prospective, population-based study in existence examines predictive associations between early or middle childhood psychopathologic disorders and later completed suicides.


OBJECTIVE
To study predictive associations between childhood psychopathologic disorders at the age of 8 years and later completed suicides and severe suicide attempts.


METHODS
Birth cohort study of individuals 8 to 24 years old.


METHODS
Finland.


METHODS
The sample includes 5302 Finnish people born in 1981 who were examined at the age of 8 years to gather information about psychopathologic conditions, school performance, and family demographics from parents, teachers, and children.


METHODS
National register-based lifetime information about completed suicides and suicide attempts that prompted hospital admission.


RESULTS
Of all 24 deaths among males between 8 and 24 years of age, 13 were suicides, whereas of 16 deaths among females, only 2 were suicides. Fifty-four males and females (1%) had either completed suicide or made a serious suicide attempt, defined as a suicide attempt that prompted hospital admission. Of 27 males with completed or serious suicide attempts, 78% screened positive on parent or teacher Rutter scales at the age of 8 years, whereas of 27 females only 11% screened positive. Among males, completed or serious suicide attempt outcome was predicted at the age of 8 years by living in a nonintact family; psychological problems as reported by the primary teacher; or conduct, hyperkinetic, and emotional problems. However, self-reports of depressive symptoms at the age of 8 years did not predict suicide outcome. No predictive associations between the study variables measured at the age of 8 years and suicide outcome were found among females. Male suicide outcome was predicted most strongly by comorbid conduct and internalizing problems.


CONCLUSIONS
Most males who completed suicide and/or made serious suicide attempts in adolescence or early adulthood had psychiatric problems by the age of 8 years, indicating a trajectory that persists throughout their lives. However, female severe suicidality is not predicted by psychopathologic disorders at the age of 8 years. The results give additional support to the importance of early detection and treatment of psychiatric problems in males.
Sourander
Andre
A
Department of Child Psychiatry, Turku University Hospital, PO Box 52, 20520 Turku, Finland. andre.sourander@utu.fi
Klomek
Anat Brunstein
AB
Niemelä
Solja
S
Haavisto
Antti
A
Gyllenberg
David
D
Helenius
Hans
H
Sillanmäki
Lauri
L
Ristkari
Terja
T
Kumpulainen
Kirsti
K
Tamminen
Tuula
T
Moilanen
Irma
I
Piha
Jorma
J
Almqvist
Fredrik
F
Gould
Madelyn S
MS
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005190:Family; D005260:Female; D005387:Finland; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010552:Personality Assessment; D011379:Prognosis; D011599:Psychopathology; D012307:Risk Factors; D013223:Statistics as Topic; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult