Nicotine Dependence in Teens Project Coordinator, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Can J Psychiatry. 2012 Jul;57(7):429-36. doi: 10.1177/070674371205700706.
OBJECTIVE: To identify early predictors of suicidal ideation in young adults, and to determine when specific time-varying determinants become important in predicting later suicidal ideation. METHODS: Data were available for 877 participants in the Nicotine Dependence in Teens study, an ongoing prospective cohort of students aged 12 to 13 years at cohort inception in 1999. Time-invariant covariates included age, sex, mother's education, language, and self-esteem. Time-varying covariates included depression symptoms, family stress, other stress, alcohol use, cigarette use, and team sports. Independent predictors of past-year suicidal ideation at age 20 years were identified in 5 multivariable logistic regression analyses, one for each of grades 7, 8, 9, 10, and 11. RESULTS: Eight per cent of participants (mean age 20.4 years [SD 0.7]; 46% male) reported suicidal ideation in the past year. In grade 7, none of the potential predictor variables were statistically significantly associated with suicidal ideation. In grade 8, participation in sports teams in and (or) outside of school protected against suicidal ideation (OR 0.6; 95% CI 0.4 to 0.8; P = 0.002). Depression symptoms in grades 9, 10, and 11 were independent predictors of suicidal ideation (OR 2.2; 95% CI 1.5 to 3.2, OR 1.6; 95% CI 1.0 to 2.5, and OR 1.9; 95% CI 1.1 to 3.4, respectively). No other variables were statistically significant in the multivariate models. CONCLUSION: Depression symptoms as early as in grade 9 predict suicidal ideation in early adulthood. It is possible that early detection and treatment of depression symptoms are warranted as part of suicide prevention programs.
目的:确定年轻人自杀意念的早期预测因素,并确定特定的时变决定因素何时在预测后期自杀意念方面变得重要。
方法:本研究的数据来自于正在进行的青少年尼古丁依赖研究的 877 名参与者,这是一个始于 1999 年的队列研究,参与者为年龄在 12 至 13 岁的学生。时不变协变量包括年龄、性别、母亲的教育水平、语言和自尊。时变协变量包括抑郁症状、家庭压力、其他压力、饮酒、吸烟和团队运动。在 5 项多变量逻辑回归分析中,分别对 7、8、9、10 和 11 年级的过去一年的自杀意念进行了独立预测因素的识别。
结果:8%的参与者(平均年龄 20.4 岁[SD 0.7];46%为男性)报告在过去一年中有自杀意念。在 7 年级时,没有任何潜在的预测变量与自杀意念有统计学上的显著相关性。在 8 年级时,参加校内外的运动队可以预防自杀意念(OR 0.6;95%CI 0.4 至 0.8;P=0.002)。9、10 和 11 年级的抑郁症状是自杀意念的独立预测因素(OR 2.2;95%CI 1.5 至 3.2;OR 1.6;95%CI 1.0 至 2.5;OR 1.9;95%CI 1.1 至 3.4)。在多变量模型中,没有其他变量具有统计学意义。
结论:早在 9 年级时出现的抑郁症状就可以预测成年早期的自杀意念。因此,作为预防自杀计划的一部分,早期检测和治疗抑郁症状是有必要的。
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