title: [Risk and risk factors of suicide attempt after first onset of suicide ideation: findings from medical students in grades 1 and 2].
abstract: OBJECTIVE
  To examine transition probabilities from first onset of suicide ideation to attempt over time among medical students in grades 1 and 2 and risk factors in the transition.
  
  
  METHODS
  A total of 10 297 college students in grades 1 and 2 from three medical schools in Anhui province were invited to complete the questionnaires, which included history of suicidal behaviors, adverse childhood experiences, family history of suicide, sociodemographic characteristics, the Beck Depression Inventory, the Beck Anxiety Inventory, the Barratt Impulsiveness Scale, the Aggressiveness Questionnaire, and the Social Support Rating Scale. Transitions were estimated using life-table analysis. Risk factors were examined using Cox regression models.
  
  
  RESULTS
  Of the 10,297 participants, 16.52% (n = 1701) reported lifetime ideation and 1.47% (n = 151) attempt. Cumulative probabilities was 8.88% for the transition from first onset of suicide ideation to attempt. The riskest probabilites of transition occurred within 1 year after onset of ideation (7.02%). 76.16% (n = 115) first attempts occurred within 1 year after onset of ideation. Cox regression models analysis found that parents' divorce ( OR = 2.32, 95% CI 1.28-4.21), physical abuse (OR = 1.69, 95% CI 1.20-2.37) , suicidal behavior history of first-degree relatives (OR = 2.02, 95% CI 1.25-3.25), impulsity (middle /lowest tertile: OR = 1.88, 95% CI 1.15-3.06, highest/lowest tertile: OR = 2.09, 95% CI 1.30 -3.36), and highest anxiety scores (highest/lowest tertile: OR = 1. 60, 95% CI 1.10-2.33)were significantly related to the transition from first onset of ideation to attempt.
  
  
  CONCLUSIONS
  Adolescent suicidal ideation signals the recent rsik for suicide attempts. Parents' divorce, physical abuse, the suicidal behavior history of first-degree relatives, impulsity, and severe anxiety score are risk factors for the transition from first onset of suicide ideation to attempt.
authors.affiliation: Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China. yangls168@sina.com
authors.forename: Linsheng
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
authors.forename: Yehuan
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors; D013337:Students, Medical / Q000523:psychology*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult