Adult Associations of Childhood Suicidal Thoughts and Behaviors: A Prospective, Longitudinal Analysis
Adult Associations of Childhood Suicidal Thoughts and Behaviors: A Prospective, Longitudinal Analysis
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DOI：
10.1016/j.jaac.2017.08.015
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发表时间：
2017-11-01
影响因子：
13.3
通讯作者：
Costello, E. Jane
中科院分区：
文献类型：
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作者：
Copeland, William E.;Goldston, David B.;Costello, E. Jane
目的：自杀的想法和行为（STBs）在青春期有其发病的高峰期，但很少有人知道这种行为是如何与以后的功能。本研究的目的是测试儿童期STBs是否与成人精神病，自杀和功能结果有关。帕拉;&帕拉;方法：这是一项前瞻性的、基于人群的社区研究，对1,420名参与者进行了长达7次的儿童/青少年（9-16岁; 6,674次观察）STB结构化访谈，包括被动和主动的想法、计划和尝试。然后，参与者在年轻的成年期（19岁，21岁，24岁和30岁; 1，273名参与者的4，556次观察）进行了4次精神病诊断，STB和功能结果。结果：到16岁时，7.0%的参与者报告了某种类型的STB，3.9%的人报告了尝试。仅意念和自杀企图都与成年期焦虑症和STBs的较高水平相关，以及在财务，健康，风险/非法和社交领域的功能低下。这些观察到的影响通常在调整其他预测儿童STBs的精神和心理社会因素（特别是虐待，抑郁症和破坏性行为障碍）后减弱。例外的是成年人的自杀行为，这是预测儿童的想法和企图，即使在完全调整的模型。患有性病的儿童和青少年更有可能在向成年的过渡中受到干扰。帕拉;&帕拉;结论：儿童期性传播感染是成年后许多精神和功能不良结果的标志，但这些影响在很大程度上是由其他因素造成的。相比之下，儿童期性传播感染是成年人自杀想法和行为的一个强有力的风险因素。
Objective: Suicidal thoughts and behavior (STBs) have their peak period of onset in adolescence, but little is known about how such behavior is associated with later functioning. The aim of this study is to test whether childhood STBs are related to adult psychiatric, suicidal, and functional outcomes.& para;& para;Method: This is a prospective, population-based community study of 1,420 participants assessed with structured interviews up to 7 times in childhood/adolescence (ages 9-16 years; 6,674 observations) for STBs including passive and active ideation, plans, and attempts. Participants were then assessed 4 times in young adulthood (ages 19, 21, 24, and 30 years; 4,556 observations of 1,273 participants) for psychiatric diagnoses, STBs, and functional outcomes.& para;& para;Results: By age 16 years, 7.0% of participants had reported some type of STBs, with 3.9% reporting an attempt. Both ideation only and suicide attempts were associated with higher levels of anxiety disorders and STBs in adulthood, as well as poor functioning across financial, health, risky/illegal, and social domains. These observed effects generally were attenuated after adjusting for other psychiatric and psychosocial factors that predict childhood STBs (particularly maltreatment, depression, and disruptive behavior disorders). The exception was adult suicidal behavior, which was predicted by both childhood ideation and attempts, even in the fully adjusted model. Children and adolescents with STBs were more likely to have had a disrupted transition to adulthood.& para;& para;Conclusion: Childhood STBs are a marker for a multitude of poor psychiatric and functional outcomes in adulthood, but these effects are largely accounted for by other factors. In contrast, childhood STBs are a robust risk factor for adult suicidal thoughts and behavior.