title: You've got to have friends: the predictive value of social integration and support in suicidal ideation among rural communities.
abstract: OBJECTIVE
  To explore the role of social integration and support in the longitudinal course of suicidal ideation (SI) in a rural population.
  
  
  METHODS
  Baseline and 12-month data were obtained from participants within the Australian Rural Mental Health Study, a longitudinal study of community residents within rural and remote New South Wales, Australia. SI was assessed using the Patient Health Questionnaire. Individual psychological factors, family and community characteristics were examined alongside personal social networks (Berkman Syme Social Network Index), availability of social support (Interview Schedule for Social Interaction) and perception of local community (Sense of Community Index).
  
  
  RESULTS
  Thirteen hundred and fifty-six participants were included in the analysis (39% male, mean age 56.5 years). Sixty-one participants reported recent SI at baseline, while 57 reported SI at follow-up. Baseline SI was a strong predictor of SI at 12 months [odds ratio (OR) 19.0, 95% confidence interval (CI) 8.6-42.3); significant effects were also observed for baseline values of psychological distress (OR 1.4, 95% CI 1.0-1.9) and availability of social support (OR 0.76, 95% 0.58-1.0) on 12-month SI. The emergence of SI at 12-month follow-up was predicted by higher psychological distress (OR 1.8, 95% CI 1.3-2.4); there was a marginal effect of lower availability of support (OR 0.74, 95% CI 0.55-1.0); neither of these variables predicted SI resolution.
  
  
  CONCLUSIONS
  This study investigated factors associated with SI over a 12-month period in a rural cohort. After controlling for known risk factors for SI, low availability of social support at baseline was associated with greater likelihood of SI at 12-month follow-up.
authors: Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, NSW, Australia. tonelle.handley@newcastle.edu.au
authors: Tonelle E
authors: TE
authors: Handley
authors: Kerry J
authors: KJ
authors: Inder
authors: Brian J
authors: BJ
authors: Kelly
authors: John R
authors: JR
authors: Attia
authors: Terry J
authors: TJ
authors: Lewin
authors: Michael N
authors: MN
authors: Fitzgerald
authors: Frances J
authors: FJ
authors: Kay-Lambkin
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D033062:Friends / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009517:New South Wales; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population / Q000706:statistics & numerical data; D012944:Social Support; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires