Comorbid psychopathological symptoms and suicidality among college students

Introduction: Suicidal thoughts and behaviors (STB) pose a major problem among college students. Mental disorders are common risk factors for STB, but fine-grained knowledge on sub-populations at risk for STB is far from settled. Methods: Web-based self-reported past year STB and past year psychopathological symptoms of KU Leuven (Leuven, Belgium) incoming freshmen (N=2,368; response rate=66.8%) were collected using items from well-validated measures. Latent class analysis was used to explore patterns of comorbid psychopathological symptoms. Post-hoc analyses explored between-class differences in STB outcomes and a wide range of sociodemographic variables. Results: Four sub-populations of STB could be differentiated (G2=36.605, df=96; p=1.000; entropy=0.919). The first sub-population (prevalence=91.9%) consisted of students without comorbid mental disorders. Within this subgroup, probability was highest for internalizing disorders (Prob=0.226), with very low risk for any other disorder (Prob<0.038). The second sub-population (prevalence=5.3%) consisted of students with eating disorder symptoms, and high risk for comorbid internalizing disorders (Prob=0.703) and/or attention deficit hyperactivity disorder (ADHD; Prob=0.388). The third sub-group (prevalence=1.6%) consisted of students with internalizing psychopathology, and high risk for multiple comorbid disorders, i.e., non-suicidal-self-injury (Prob=0.715), eating disorder symptoms (Prob=0.606), ADHD (Prob=0.330) and/or psychotic symptoms (Prob=0.295). A fourth sub-population (prevalence=1.3%) consisted of students with substance use problems, and high risk for comorbid internalizing disorders (Prob=0.803) and/or ADHD (Prob=0.516). STB was more common in the 2nd, 3rd, and 4th sub-population, especially in those with highly comorbid internalizing disorders (62.5% vs. 5.8%; p