Polek, Ela;
Neufeld, Sharon;
Wilkinson, Paul;
Goodyer, Ian;
St. Clair, Michelle;
Prabhu, Gita;
Dolan, Ray;
... Jones, Peter B; + view all
(2018)
Replicable Associations Between Common Mental Distress and Suicide Risk in Young People: Implications for Clinical Practice and Population Suicide Prevention.
SSRN: Amsterdam, Netherlands.
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Abstract
Background: Recent evidence suggests that multiple symptoms or diagnoses, partucularly when co-ocuring with non-suicidal self-harm, predict suicide risk more strongly than single diagnosis. / Method: Suicidal thought (ST) and non-suicidal self-injury (NSSI) were studies in two independent longitudinal UK samples of young people: the Neuroscience in Psychiatry (NSPN) 2400 cohort (n=2403) and the ROOTS cohort (n=1074). Participants, age 14-24 years, were recruited from primary health care registers, schools and colleges, and advertisements to complete quotas in age-sex strata. We calculated a score on a latent construct Common Mental Distress (the summary measure indexing a broad range of symptoms conventionally seen as components of distinct disorders). We examined the relative prevalence of ST and NSSI over the population distribution of mental distress; we used logistic regressions, IRT and ROC analyses to determine associations between suicide risks and mental distress (in continuous and above-the-norm categorical format); and pathway mediation models to examine longitudinal associations. / Outcomes: We found a dose-response relationship between levels of mental distress and suicide risk. In both cohorts the majority of all subjects experiencing ST (78% and 76%) and NSSI (66% and 71%) had scores on mental distress no more than two standard deviations above the population mean; higher scores indicated highest risk but were, by definition, infrequent. Mental distress contributed to the longitudinal persistence of ST and NSSI. / Interpretation: Universal prevention strategies reducing levels of mental distress in the whole population (in addition to screening) may prevent more suicides than approaches targeting youths with psychiatric disorders.
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