The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student Initiative
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Date
2025-08-01
Open Access Location
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier B V
Rights
(c) The author/s
CC BY
CC BY
Abstract
Objective:
To investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students.
Method:
Poisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes.
Results:
Lifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4–7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5–7.7]), followed by MDx (RR range 1.3–3.0). Of the demographic subgroups, transgender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3–2.6]; ideation-to-attempt transition RR=1.5 [1.3–1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9–2.2]), major depressive disorder (RR=2.0 [1.9–2.1]), and bipolar disorder (RR=1.8 [1.6–2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3–1.7]), bipolar disorder (RR=1.4 [1.2–1.7]), and sexual abuse (RR=1.4 [1.2–1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0–1.8]).
Conclusion:
CAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.
Description
Keywords
Suicide, Self-injurious behavior, Students, Mental health, Adverse childhood experiences, Prevalence, Risk factors
Citation
Mortier P, Yang X, Altwaijri YA, Holdcraft JA, Lee S, Sampson NA, Albor Y, Alhadi AN, Alonso J, Al-Saud NK, Andersson C, Atwoli L, Auerbach RP, Muaka CA, Báez-Mansur PM, Ballester L, Bantjes J, Baumeister H, Bendtsen M, Benjet C, Berman AH, Bruffaerts R, Carrasco P, Chan SCN, Cohut I, Covarrubias Díaz Couder MA, Crockett MA, Cuijpers P, David OA, Dong D, Ebert DD, Gaete J, Felez-Nobrega M, García Forero C, Gili M, Gutiérrez-García RA, Haro JM, Hasking P, Hunt X, Husky MM, Jaguga F, Jansen L, Langer ÁI, Liu Y, Mac-Ginty S, Martínez V, Mason A, Mathai M, McLafferty M, Miranda-Mendizabal A, Murray EK, Musyoka CM, O'Neill SM, Papasteri CC, Piqueras JA, Popescu CA, Rapsey C, Robinson K, Rodriguez-Jimenez T, Scarf D, Siu OL, Stein DJ, Struijs SY, Tomoiaga CT, Valdés-García KP, Vereecke S, Vigo DV, Wang AY, Wong SYS, Kessler RC. (2025). The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student Initiative. Psychiatry Research. 350.