Maria Jesús Blasco1,2,3, Gemma Vilagut1,3, José Almenara4, Miquel Roca5, José Antonio Piqueras6, Andrea Gabilondo7, Carolina Lagares4, Victoria Soto-Sanz6, Itxaso Alayo1,3, Carlos G Forero1,2,3, Enrique Echeburúa8, Margalida Gili5, Ana Isabel Cebrià9, Ronny Bruffaerts10, Randy P Auerbach11, Matthew K Nock12, Ronald C Kessler13, Jordi Alonso1,2,3. 1. Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain. 2. Pompeu Fabra University (UPF), Barcelona, Spain. 3. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 4. University of Cadiz (UCA), Cadiz, Spain. 5. Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain. 6. Miguel Hernandez University (UMH), Elche, Spain. 7. Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Basque Country, San Sebastián, Spain. 8. University of the Basque Country (UPV-EHU), San Sebastián, Spain. 9. Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain. 10. Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium. 11. Department of Psychiatry, Harvard Medical School, Center for Depression, Anxiety and Stress Research, McLean Hospital, Boston, MA, USA. 12. Department of Psychology, Harvard University, Boston, MA, USA. 13. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Abstract
OBJECTIVE: We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental). METHODS: First-year university students completed an online survey including Self-Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia-Suicide Severity Rating Scale (C-SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared. RESULTS: A total of 2,118 students completed the survey (mean age = 18.8 [SD = 1.4] years; 55.4% female). Twelve-month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12-month SI were as follows: parental psychopathology (OR = 1.7, 95% CI 1.2-2.5); sexual assault (OR = 5.6, 95% CI 1.4-22.1); lifetime mood disorder (OR = 5.2, 95% CI 3.5-7.7); and lifetime anxiety disorder (OR = 1.7, 95% CI: 1.1-2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR = 0.6, 95% CI 0.4-0.9 for the second highest tertile) and family (OR = 0.4, 95% CI 0.3-0.7 for the highest tertile). AUC of the final model was 0.82 (SE = 0.015). CONCLUSION: Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model.
OBJECTIVE: We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental). METHODS: First-year university students completed an online survey including Self-Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia-Suicide Severity Rating Scale (C-SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared. RESULTS: A total of 2,118 students completed the survey (mean age = 18.8 [SD = 1.4] years; 55.4% female). Twelve-month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12-month SI were as follows: parental psychopathology (OR = 1.7, 95% CI 1.2-2.5); sexual assault (OR = 5.6, 95% CI 1.4-22.1); lifetime mood disorder (OR = 5.2, 95% CI 3.5-7.7); and lifetime anxiety disorder (OR = 1.7, 95% CI: 1.1-2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR = 0.6, 95% CI 0.4-0.9 for the second highest tertile) and family (OR = 0.4, 95% CI 0.3-0.7 for the highest tertile). AUC of the final model was 0.82 (SE = 0.015). CONCLUSION: Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model.
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