Philippe Mortier1, Randy P Auerbach2, Jordi Alonso3, Jason Bantjes4, Corina Benjet5, Pim Cuijpers6, David D Ebert7, Jennifer Greif Green8, Penelope Hasking9, Matthew K Nock10, Siobhan O'Neill11, Stephanie Pinder-Amaker12, Nancy A Sampson13, Gemma Vilagut3, Alan M Zaslavsky13, Ronny Bruffaerts14, Ronald C Kessler13. 1. Research Group Psychiatry, KU Leuven University, Leuven, Belgium. Electronic address: philippe.mortier@upckuleuven.be. 2. Harvard Medical School, Boston, and the Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA. 3. Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 4. Stellenbosch University, South Africa. 5. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. 6. Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. 7. Clinical Psychology and Psychotherapy Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany. 8. School of Education, Boston University, Boston, MA. 9. School of Psychology, Curtin University, Perth, Australia. 10. Harvard University, Cambridge, MA. 11. School of Biomedical Sciences, Ulster University, Derry-Londonderry, Northern, Ireland. 12. Harvard Medical School, Boston, and McLean Hospital, Belmont, MA. 13. Harvard Medical School, Boston, MA. 14. Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium.
Abstract
OBJECTIVE: College entrance may be a strategically well-placed "point of capture" for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students. METHOD: Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, and the United States). RESULTS: Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. The 12-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About three-fourths of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range of 41% to 53%. About one-half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted odds ratio [aOR] = 1.7). Nonheterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1). CONCLUSION: The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.
OBJECTIVE: College entrance may be a strategically well-placed "point of capture" for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students. METHOD: Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, and the United States). RESULTS: Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. The 12-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About three-fourths of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range of 41% to 53%. About one-half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted odds ratio [aOR] = 1.7). Nonheterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1). CONCLUSION: The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.
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