Childhood adversities and risk for suicidal ideation and attempts: A longitudinal population-based study

Department of Psychiatry and Community Health Sciences, University of Manitoba, Canada.
Psychological Medicine (Impact Factor: 5.94). 01/2007; 36(12):1769-78. DOI: 10.1017/S0033291706008646
Source: PubMed

ABSTRACT Developmental adversities may be risk factors for adult suicidal behavior, but this relationship has rarely been studied prospectively. The present study examined the association between childhood adversities and new onset suicidal ideation and attempts in an adult population-based sample.
The study used a large community mental health survey (the Netherlands Mental Health Survey and Incidence Study; n=7076, age range 18-64 years). Logistic regression analyses were used to evaluate the relationship between childhood adversities and new onset of suicidal ideation and attempts over 3 years of longitudinal follow-up.
During the study period 85 new cases of suicidal ideation and 39 new onset suicide attempts were observed. The incidence rate for new suicide ideation was 0.67% per year and the incidence rate for new suicide attempts was 0.28% per year. Childhood neglect, psychological abuse and physical abuse were strongly associated with new onset suicidal ideation and suicide attempts. Odds ratios (ORs) ranged from 2.80 to 4.66 for new onset suicidal ideation and from 3.60 to 5.43 for new onset suicide attempts. The total number of adversities reported had a strong graded relationship to new onset suicidal ideation and attempts. These associations remained significant after controlling for the effects of mental disorders.
Childhood abuse and multiple adversities are strongly associated with future suicidal behavior and the mental disorders assessed in the present study do not fully account for this effect. A comprehensive understanding of suicidal behavior must take childhood adversities into account.

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    • "As hypothesized , depressed postpartum women who experi - enced childhood physical abuse were at significantly increased risk for frequent thoughts of self - harm . Other reports similarly indi - cated a 3e4 - fold increased risk for SI ( Brown et al . , 1999 ; Enns et al . , 2006 ; Fuller - Thomson et al . , 2012 ; McCauley et al . , 1997 ; McHolm et al . , 2003 ) or suicide attempt ( Brodsky et al . , 2001 ; Dube et al . , Table 3 Clinical measures by response to EPDS item 10 ."
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    ABSTRACT: Suicide is one of the leading causes of death in postpartum women. Identifying modifiable factors related to suicide risk in mothers after delivery is a public health priority. Our study aim was to examine associations between suicidal ideation (SI) and plausible risk factors (experience of abuse in childhood or as an adult, sleep disturbance, and anxiety symptoms) in depressed postpartum women. This secondary analysis included 628 depressed mothers at 4-6 weeks postpartum. Diagnosis was confirmed with the Structured Clinical Interview for DSM-IV. We examined SI from responses to the Edinburgh Postnatal Depression Scale-EPDS item 10; depression levels on the Structured Interview Guide for the Hamilton Depression Rating Scale, Atypical Depression Symptoms (SIGH-ADS); plus sleep disturbance and anxiety levels with subscales from the EPDS and SIGH-ADS items on sleep and anxiety symptoms. Of the depressed mothers, 496 (79%) 'never' had thoughts of self-harm; 98 (15.6%) 'hardly ever'; and 34 (5.4%) 'sometimes' or 'quite often'. Logistic regression models indicated that having frequent thoughts of self-harm was related to childhood physical abuse (odds ratio-OR = 1.68, 95% CI = 1.00, 2.81); in mothers without childhood physical abuse, having frequent self-harm thoughts was related to sleep disturbance (OR = 1.15, 95% CI = 1.02, 1.29) and anxiety symptoms (OR = 1.11, 95% CI = 1.01, 1.23). Because women with postpartum depression can present with frequent thoughts of self-harm and a high level of clinical complexity, conducting a detailed safety assessment, that includes evaluation of childhood abuse history and current symptoms of sleep disturbance and anxiety, is a key component in the management of depressed mothers. Copyright © 2015 Elsevier Ltd. All rights reserved.
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    • "Screening for impulsivity as well as hopelessness may increase clinicians' ability to identify those at greatest risk of self-harm and suicidal behavior. In a longitudinal study (Enns et al., 2006), childhood neglect, psychological abuse, and physical abuse were all strongly associated with new onset ideation and suicide attempts, even after controlling for the effects of mental disorders. Moreover, Andover et al. (2007) found that individuals with a history of suicide attempts were more likely to report histories of childhood physical and sexual abuse compared to those without a suicide attempt history. "
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    ABSTRACT: In the current cross-sectional study, we aimed to investigate the presence and severity of "male" depressive symptoms and suicidal behaviors in psychiatric patients with and without a history of child abuse and neglect, as measured by the Childhood Trauma Questionnaire (CTQ), as well as to explore the associations among childhood maltreatment, "male depression" and suicide risk. The sample consisted of 163 consecutively admitted adult inpatients (80 men; 83 women). The patients were administered the CTQ, Gotland Male Depression Scale (GMDS), and Suicidal History Self-Rating Screening Scale (SHSS). Those with a moderate-severe childhood maltreatment history were more likely to be female (p<0.05) and reported more "male depression" (p<0.001) and suicidal behaviors (p<0.01) as compared to those not having or having a minimal history of child abuse and neglect. In the multivariate analysis, only the minimization/denial scale of the CTQ (odds ratio=0.31; p<0.001) and "male depression" (odds ratio=1.83; p<0.05) were independently associated with moderate/severe history of child maltreatment. The findings suggest that exposure to abuse and neglect as a child may increase the risk of subsequent symptoms of "male depression", which has been associated with higher suicidal risk.
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    • "Psychological abuse was defined as the verbal and symbolic acts used by the parent to cause psychological pain or fear on the part of the child (Straus et al., 1998). Psychological abuse was shown to be associated with adolescent and adult suicidal ideation and attempts (Enns et al., 2006; Locke & Newcomb, 2005). A specific form of child psychological abuse, maternal verbal assault involving verbal threats and hostility, was identified to be associated with increased risk for suicide attempts during late adolescence (Johnson et al., 2002). "
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