Childhood adversities as risk factors for onset and persistence of suicidal behaviour

Background Suicide is a leading cause of death worldwide, but the precise effect of childhood adversities as risk factors for the onset and persistence of suicidal behaviour (suicide ideation, plans and attempts) are not well understood. Aims To examine the associations between childhood adversities as risk factors for the onset and persistence of suicidal behaviour across 21 countries worldwide. Method Respondents from nationally representative samples (n = 55 299) were interviewed regarding childhood adversities that occurred before the age of 18 years and lifetime suicidal behaviour. Results Childhood adversities were associated with an increased risk of suicide attempt and ideation in both bivariate and multivariate models (odds ratio range 1.2-5.7). The risk increased with the number of adversities experienced, but at a decreasing rate. Sexual and physical abuse were consistently the strongest risk factors for both the onset and persistence of suicidal behaviour, especially during adolescence. Associations remained similar after additional adjustment for respondents` lifetime mental disorder status. Conclusions Childhood adversities (especially intrusive or aggressive adversities) are powerful predictors of the onset and persistence of suicidal behaviours.US National Institute of Mental Health (NIMH/NIH)[R01MH070884]US National Institute of Mental Health (NIMH/NIH)[MH077883]John D. and Catherine T. MacArthur FoundationPfizer FoundationUS Public Health Service[R13-MH066849]US Public Health Service[R01-MH069864]US Public Health Service[R01 DA016558]Fogarty International Center (FIRCA/NIH)[R03-TW006481]Pan American Health Organization (PAHO)Eli Lilly & Company FoundationOrtho-McNeil Pharmaceutical, IncGlaxoSmithKline and Bristol-Myers SquibbState of Sao Paulo Research Foundation (FAPESP)[03/00204-3]Ministry of HealthNational Center for Public Health ProtectionShenzhen Bureau of HealthShenzhen Bureau of Science, Technology, and InformationMinistry of Social ProtectionEuropean Commission[QLG5-1999-01042]European Commission[SANCO 2004123]Piedmont Region (Italy)Fondo de Investigacion Sanitaria, Institut de Salud Carlos III, Spain[FIS 00/00281]Ministerio de Ciencia y Tecnologia, Spain (SAF)[2000-158-CE]Departament de Salut, Generalitat de Catalunya, SpainInstitut Be Salud Carlos III[CB06/02/0046]Institut Be Salud Carlos III[RD06/0011]WHO (India)Israel National Institute for Health Policy and Health Services ResearchNational Insurance Institute of IsraelJapan Ministry of Health, Labour and Welfare[H13-SHOGAI-023]Japan Ministry of Health, Labour and Welfare[H14-TOKUBETSU-026]Japan Ministry of Health, Labour and Welfare[H16-KOKORO-013]Lebanese Ministry of Public HealthWHO (Lebanon)Janssen CilagEli LillyGlaxoSmithKlineRocheNovartisNational Institute of Psychiatry Ramon Be la Fuente (INPRFMDIES)[42801]National Council on Science and Technology[CONACyT-G30544-H]Pan American Health Organization (PAHO)New Zealand Ministry of HealthAlcohol Advisory CouncilHealth Research CouncilWHO (Geneva)WHO (Nigeria)Federal Ministry of Health, Abuja, NigeriaMinistry of Public Health (former ministry of Health) with supplemental support of Eli Lilly Romania SRLUS National Institute of Mental Health (NIMH/NIH)[R01-MH059575]US National Institute of Mental Health (NIMH/NIH)[R01-MH61905]South African Department of HealthUniversity of MichiganUS National Institute of Mental Health (NIMH/NIH) with supplemental support from NIDA[U01-MH60220]Substance Abuse and Mental Health Services Administration (SAMHSA)Robert Wood Johnson Foundation (RWJF)[044708]John W. Alden Tru