title: First onset of suicidal thoughts and behaviours in college.
abstract: College students are a worldwide increasing group of young people at risk for suicidal thoughts and behaviours (STB). However, no previous studies have prospectively investigated the first onset of STB during the college period.
  
  
  
  Using longitudinal data from the Leuven College Surveys, 2337 (response rate [RR]=66.6%) incoming freshmen provided baseline data on STB, parental psychopathology, childhood-adolescent traumatic experiences, 12-month risk for mental disorders, and 12-month stressful experiences. A total of 1253 baseline respondents provided data on 12-month STB in a two-year annual follow-up survey (conditional RR=53.6%; college dropout adjusted conditional RR=70.2%).
  
  
  
  One-year incidence of first-onset STB was 4.8-6.4%. Effect sizes of the included risk factors varied considerably whether viewed from individual-level (ORs=1.91-17.58) or population-level perspective (PARPs=3.4-34.3%). Dating violence prior to the age of 17, physical abuse prior to the age of 17, and 12-month betrayal by someone else than the partner were most strong predictors for first-onset suicidal ideation (ORs=4.23-12.25; PARPs=8.7-27.1%) and plans (ORs=6.57-17.58; PARPs=15.2-34.3%). Multivariate prediction (AUC=0.84-0.91) revealed that 50.7-65.7% of first-onset STB cases were concentrated in the 10% at highest predicted risk.
  
  
  
  As this is a first investigation of STB onset in college, future studies should use validation samples to test the accuracy of our multivariate prediction model.
  
  
  
  The first onset of STB in college appears to be higher than in the general population. Screening at college entrance is a promising strategy to identify those students at highest prospective risk, enabling the cost-efficient clinical assessment of young adults in college.
authors.affiliation: Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium. Electronic address: philippe.mortier@uzleuven.be.
authors.forename: P
authors.initials: P
authors.lastname: Mortier
authors.affiliation: Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Demyttenaere
authors.affiliation: Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Belmont, MA, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Auerbach
authors.affiliation: Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: School of Education, Boston University, Boston, MA, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Green
authors.affiliation: Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Kiekens
authors.affiliation: Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, MA, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: Department of Psychology, Harvard University, Boston, MA, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Nock
authors.affiliation: Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, MA, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Zaslavsky
authors.affiliation: Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Bruffaerts
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D013997:Time Factors; D014495:Universities; D055815:Young Adult
keywords: College student; Individual-level risk; Population-level risk; Prediction model; Suicidal ideation; Suicide plan