Abstract
BackgroundAlthough the cross-sectional association between mental disorders and suicide ideation is well studied, less is known about the prospective association. In this paper, we estimated among those without 12-month suicide ideation at baseline, the association between a wide variety of common mental disorders at baseline and suicide ideation within the 6-year follow-up period, after controlling for history of other mental disorders and demographic variables.MethodsData were used from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a prospective representative adult cohort study with baseline (n = 6646) with a 6-year follow-up period. Lifetime mental disorders were assessed at baseline with the Composite International Diagnostic Interview 3.0. Within the longitudinal design, participants with first time or recurrent suicide ideation were defined follows: having no suicide ideation in the 12 months before the baseline assessment, and reporting to have had seriously thought about suicide between baseline and the 6-year follow-up period. Multiple logistical regression was used to estimate the longitudinal association between suicide ideation and a specific mental disorder while controlling for comorbidity and baseline variables. To account for the prevalence of a disorder in the population, for each disorder, the population attributable risk proportion (PARP) was calculated.Results2.9% (n = 132) of the participants that did not report suicide ideation in the past 12 months at baseline reported suicide ideation at follow-up. Of these 132 cases, 81 (61%) experienced suicide ideation for the first time in their lives and could be viewed as first onset cases. 51 (39%) reported recurrent suicide ideation. After controlling for comorbidity, the only two disorders that were significantly related to suicide ideation at follow-up were lifetime major depressive disorder (MDD) and generalized anxiety disorder (GAD). PARP for MDD was 47.8 and 16.6% for GAD.ConclusionsAfter controlling for all other mental disorders, a lifetime history of MDD and GAD were related to suicide ideation at follow-up. For clinical practice, this indicates that patients with a history of MDD or GAD stay vulnerable for suicide ideation, even though they did not report suicide ideation in the past year.
Highlights
The cross-sectional association between mental disorders and suicide ideation is well studied, less is known about the prospective association
Analysis of a community sample survey with a 13 year follow-up indicated that especially major depressive disorder (MDD) and substance abuse were related to the first onset of suicide ideation and suicide attempts, the authors did not control for comorbidity [13]
Cross-sectional association between lifetime mental disorders and lifetime suicidal behavior Lifetime history of suicide ideation Table 1 shows that 83.0% of the respondents with a lifetime history of suicide ideation reported a lifetime history of an axis-I disorder
Summary
The cross-sectional association between mental disorders and suicide ideation is well studied, less is known about the prospective association. One of the most well established statistics in suicide prevention is that mental disorders play an important role in 90% of all suicides [7, 8] This number has been up for debate [9], many cross-national population based studies confirmed the association between a history of mental disorders and suicide ideation, suicide attempts and completed suicides [4, 10, 11]. We used data of the second Dutch longitudinal population-based study (Netherlands Mental Health Survey and Incidence Study-2: NEMESIS-2), to estimate the longitudinal association of a wide variety of common mental disorders and suicide ideation after controlling for demographic variables and comorbidity
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