title: A population-based longitudinal study of recent stressful life events as risk factors for suicidal behavior in major depressive disorder.
abstract: The purpose of this study is to investigate whether the type and number of stressful life events (SLEs) will be associated with suicidal behavior in a 3-year follow-up period in persons with major depressive disorder (MDD). Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative longitudinal survey of mental health in non-institutionalized adults in the United States. The survey consisted of two waves: Wave 1 (2001--2002) and Wave 2 (2004-2005), n = 34,653. Twelve past-year SLEs were assessed at baseline. These SLEs were categorized into the following groups based on previous research: Loss or victimization; Relationship, friendship, or interpersonal stress; Financial stress; and Legal problems. Only respondents with MDD at Wave 1 were included (n = 6,004). Several SLEs were strongly associated with suicide attempts, among which, "serious problems with neighbor, friend, or relative" (adjusted odds ratio [AOR] = 2.21; 95% confidence interval [95% CI]: 1.41, 3.45) and "major financial crisis, bankruptcy, or unable to pay bills" (AOR = 2.31; 95% CI: 1.45, 3.66) were the most robust predictors of suicide attempts even after adjusting for sociodemographic variables and any anxiety, substance use, or personality disorder. People with MDD who had been exposed to certain SLEs are at elevated risk for future suicide attempts, even after accounting for the demographic factors and psychiatric comorbidity.
authors.affiliation: a Department of Psychology , University of Manitoba , Winnipeg , Manitoba , Canada.
authors.forename: Yunqiao
authors.initials: Y
authors.lastname: Wang
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.forename: Tracie O
authors.initials: TO
authors.lastname: Afifi
authors.forename: Shay-Lee
authors.initials: SL
authors.lastname: Bolton
authors.forename: Edward A
authors.initials: EA
authors.lastname: Johnson
authors.forename: James M
authors.initials: JM
authors.lastname: Bolton
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: depression; financial stress; mental disorders; stressful life events; suicide attempt