First onset of suicidal thoughts and behaviours in college

P. Mortier , K. Demyttenaere, R. Auerbach, Pim Cuijpers, J.G. Green, G. Kiekens , R.C. Kessler, M.K. Nock , A. Zaslavsky, R Bruffaerts

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College students are a worldwide increasing group of young people at risk for suicidal thoughts and behaviours (STB). However, no previous studies have prospectively investigated the first onset of STB during the college period.

Using longitudinal data from the Leuven College Surveys, 2337 (response rate [RR]=66.6%) incoming freshmen provided baseline data on STB, parental psychopathology, childhood-adolescent traumatic experiences, 12-month risk for mental disorders, and 12-month stressful experiences. A total of 1253 baseline respondents provided data on 12-month STB in a two-year annual follow-up survey (conditional RR=53.6%; college dropout adjusted conditional RR=70.2%).

One-year incidence of first-onset STB was 4.8–6.4%. Effect sizes of the included risk factors varied considerably whether viewed from individual-level (ORs=1.91–17.58) or population-level perspective (PARPs=3.4–34.3%). Dating violence prior to the age of 17, physical abuse prior to the age of 17, and 12-month betrayal by someone else than the partner were most strong predictors for first-onset suicidal ideation (ORs=4.23–12.25; PARPs=8.7–27.1%) and plans (ORs=6.57–17.58; PARPs=15.2–34.3%). Multivariate prediction (AUC=0.84–0.91) revealed that 50.7–65.7% of first-onset STB cases were concentrated in the 10% at highest predicted risk.

As this is a first investigation of STB onset in college, future studies should use validation samples to test the accuracy of our multivariate prediction model.

The first onset of STB in college appears to be higher than in the general population. Screening at college entrance is a promising strategy to identify those students at highest prospective risk, enabling the cost-efficient clinical assessment of young adults in college.
Original languageEnglish
Pages (from-to)291-299
Number of pages9
JournalJournal of Affective Disorders
Early online date28 Sept 2016
Publication statusPublished - 1 Jan 2017


FundersFunder number
Ortho-McNeil Pharmaceutical
US Public Health ServiceR01 DA016558, R13-MH066849, R01-MH069864
National Institute of Mental HealthR01MH070884
Fogarty International CenterR03TW006481
John D. and Catherine T. MacArthur Foundation
Eli Lilly and CompanyIIT-H6U-BX-I002
Pfizer Foundation
Pan American Health Organization
Fonds De La Recherche Scientifique - FNRS11N0514N/11N0516N
Koning Boudewijnstichting2014-J2140150-102905


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