title: Examination of the population attributable risk of different risk factor domains for suicidal thoughts and behaviors.
abstract: BACKGROUND
  Despite the fact that suicide is an important public health problem, the etiology is still not well understood. Especially lacking is a societal-level approach that takes into account the extent to which several risk factor domains are attributable to new onset of suicidal thoughts and behaviors (STB).
  
  
  METHODS
  Data stem from a cross-sectional population study of the non-institutionalized adult (18+) population from Belgium (N=2419). The third version of the Composite International Diagnostic Interview (CIDI-3.0) was administered to assess lifetime STB and risk factor domains. Multivariate approaches, expressed in population attributable risk proportions, were used to estimate the proportion of new onset cases of STB related to the occurrence of different risk factors.
  
  
  RESULTS
  Approximately 38% of cases of suicidal ideation onset were attributable to mental disorders, 20% to chronic physical conditions, and another 13% to parental psychopathology. Suicide attempts in the general population were attributable to mental disorders (PARP=48%), but attempts among persons with suicidal ideation were unrelated to mental disorders, but rather to trauma (PARP=17%) and childhood adversities (PARP=12%).
  
  
  CONCLUSIONS
  This is an explorative study using multivariate additive general models that generates specific hypotheses on the development of STB onset rather than testing specific pathways in the process of STB.
  
  
  CONCLUSIONS
  New onset STB is mostly attributable to proximal risk factors such as mental disorders. However, distal risk factors like childhood adversities or trauma also play a considerable role in the new onset of STB, especially in the transition from suicide ideation to suicide attempt.
authors: Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium. Electronic address: ronny.bruffaerts@med.kuleuven.be.
authors: Ronny
authors: R
authors: Bruffaerts
authors: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. Electronic address: kessler@hcp.med.harvard.edu.
authors: Ronald C
authors: RC
authors: Kessler
authors: Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium. Electronic address: koen.demyttenaere@med.kuleuven.be.
authors: Koen
authors: K
authors: Demyttenaere
authors: Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium. Electronic address: anke.bonnewyn@uzleuven.be.
authors: Anke
authors: A
authors: Bonnewyn
authors: Department of Psychology, Harvard University, Cambridge, MA, USA. Electronic address: nock@wjh.harvard.edu.
authors: Matthew K
authors: MK
authors: Nock
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult