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Cited by 310Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseGrief, Bereavement, and Mental Health

Suicide Attempt in Young People: A Signal for Long-term Health Care and Social Needs

Open access
Goldman-Mellor, Sidra J., Caspi, Avshalom, Harrington, HonaLee, Hogan, Sean, Nada-Raja, Shyamala, Poulton, Richie, Moffitt, Terrie E.·2014·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2013.2803PMC PMC3946312
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Abstract

IMPORTANCE: Suicidal behavior has increased since the onset of the global recession, a trend that may have long-term health and social implications. OBJECTIVE: To test whether suicide attempts among young people signal increased risk for later poor health and social functioning above and beyond a preexisting psychiatric disorder. DESIGN: We followed up a cohort of young people and assessed multiple aspects of their health and social functioning as they approached midlife. Outcomes among individuals who had self-reported a suicide attempt up through age 24 years (young suicide attempters) were compared with those who reported no attempt through age 24 years (nonattempters). Psychiatric history and social class were controlled for. SETTING AND PARTICIPANTS: The population-representative Dunedin Multidisciplinary Health and Development Study, which involved 1037 birth cohort members comprising 91 young suicide attempters and 946 nonattempters, 95% of whom were followed up to age 38 years. MAIN OUTCOMES AND MEASURES: Outcomes were selected to represent significant individual and societal costs: mental health, physical health, harm toward others, and need for support. RESULTS: As adults approaching midlife, young suicide attempters were significantly more likely to have persistent mental health problems (eg, depression, substance dependence, and additional suicide attempts) compared with nonattempters. They were also more likely to have physical health problems (eg, metabolic syndrome and elevated inflammation). They engaged in more violence (eg, violent crime and intimate partner abuse) and needed more social support (eg, long-term welfare receipt and unemployment). Furthermore, they reported being lonelier and less satisfied with their lives. These associations remained after adjustment for youth psychiatric diagnoses and social class. CONCLUSIONS AND RELEVANCE: Many young suicide attempters remain vulnerable to costly health and social problems into midlife. As rates of suicidal behavior rise with the continuing global recession, additional suicide prevention efforts and long-term monitoring and after-care services are needed.

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2013.2803

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 13 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    As they neared midlife, young attempters showed more mental health problems than non-attempters.

    “Approaching midlife, young suicide attempters had more mental health problems than non-attempters (Table 1).”
    Quote in the paperSubstantial claim
  • Findingown data

    The links between youth suicide attempt and adult outcomes persisted after accounting for youth psychiatric diagnoses and social class.

    “These associations remained after adjustment for youth psychiatric diagnoses and social class.”
    Quote in the paperSubstantial claim
  • Findingown data

    Young attempters needed more social support in adulthood.

    “Young suicide attempters were in need of greater support during adulthood (Table 3).”
    Quote in the paperSubstantial claim
  • Findingown data

    Young attempters were much more likely than non-attempters to commit violence toward others.

    “Approaching midlife, young suicide attempters were significantly more likely than non-attempters to commit violence against others (Table 3).”
    Quote in the paperSubstantial claim
  • Findingown data

    Young attempters had significantly worse physical health as they neared midlife.

    “Young suicide attempters were in significantly worse physical health as they approached midlife (Table 2).”
    Quote in the paperSubstantial claim
  • May combine two claims. 6
  • Classified as probably not a substantial claim. 1

  • May combine two claims.

    Findingown data

    Young attempters had higher rates of depression, anxiety, and conduct disorder before or at their first attempt.

    “young suicide attempters were significantly more likely to have a history of depression (32.2% vs. 44.0%, χ2=5.15, p=.02), anxiety (20.3% vs. 34.1%, χ2=9.35, p=.002), and conduct disorder (20.8% vs. 48.4%, χ2=35.16, p<.0001) during the exposure period.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Although they were just under 9% of the cohort, by midlife young attempters made up 15% of metabolic syndrome cases, 22% of persistent psychiatric disorder cases, and 35% of violent crime convictions.

    “Although they made up just under nine percent of our cohort, by midlife they comprised 15 percent of those with metabolic syndrome, 22 percent of those with persistent psychiatric disorders, and 35 percent of those who were convicted for violent crime (Figure 1).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    As they neared midlife, young attempters reported more loneliness and lower life satisfaction.

    “approaching midlife, they reported suffering from loneliness and were less satisfied with their lives.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    At the age-38 assessment, 95% of the 1,007 living cohort members took part.

    “when 95% of the 1,007 Study members still alive took part.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Adding family social class as a covariate to all models slightly attenuated some point estimates but did not change statistical inference.

    “Point estimates for some outcomes were very slightly attenuated, but statistical inference was unaltered in all cases (i.e., no statistically significant findings were lost and no new significant findings were gained).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A prior suicide attempt strongly predicts later attempts and completed suicide.

    “previous suicide attempt is one of the strongest predictors of future attempts, as well as of completed suicide.9-17”
    Quote in the paperSubstantial claim0 of 9 sources checked
    • cites [9] Joiner TE Conwell Y Fitzpatrick KK Four studies on how past and current suicidality relate even when “everything but the kitchen sink” is covaried J. Abnorm. Psychol 2005 114 2 291 303 15869359

      Not checked in the free run.

    • cites [10] Haukka J Suominen K Partonen T Lonnqvist J Determinants and outcomes of serious attempted suicide: a nationwide study in Finland, 1996-2003 Am. J. Epidemiol 2008 167 10 1155 1163 18343881

      Not checked in the free run.

    • cites [11] Borges G Angst J Nock MK Ruscio AM Walters EE Kessler RC A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R) Psychol. Med 2006 36 12 1747 1757 16938149 PMC1924761

      Not checked in the free run.

    • cites [12] Spirito A Esposito-Smythers C Attempted and completed suicide in adolescence Annu. Rev. Clin. Psychol 2006 2 237 266 17716070

      Not checked in the free run.

    • cites [13] Beautrais AL Subsequent mortality in medically serious suicide attempts: a 5 year follow-up Aust. N. Z. J. Psychiatry 2003 37 5 595 599 14511088

      Not checked in the free run.

    • cites [14] Brown GK Beck AT Steer RA Grisham JR Risk factors for suicide in psychiatric outpatients: A 20-year prospective study J. Consult. Clin. Psychol 2000 68 3 371 377 10883553

      Not checked in the free run.

    • cites [15] Tejedor MC Diaz A Castillon JJ Pericay JM Attempted suicide: Repetition and survival - findings of a follow-up study Acta Psychiatr. Scand 1999 1999 100 10493087

      Not checked in the free run.

    • cites [16] Shaffer D Gould MS Fisher P Psychiatric diagnosis in child and adolescent suicide Arch. Gen. Psychiatry 1996 53 4 339 348 8634012

      Not checked in the free run.

    • cites [17] Nock MK Kessler RC Prevalence of and risk factors for suicide attempts versus suicide gestures: analysis of the National Comorbidity Survey J. Abnorm. Psychol 2006 115 3 616 623 16866602

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The study used a representative birth cohort with good retention, over 13 years of follow-up, and statistical controls for psychiatric diagnoses.

    “Methodological advantages of this study include its use of a representative birth cohort with good retention, a follow-up period of more than 13 years, and statistical controls for psychiatric diagnoses among young suicide attempters.”
    Quote in the paperSubstantial claim
7 of 7

  • The paper relies on this without support.

    Only a few studies have examined outcomes following a suicide attempt beyond future attempts.

    “Only a few studies, however, have looked at additional outcomes following a suicide attempt.”

  • The paper relies on this without support.

    The global recession will continue.

    “As rates of suicidal behavior rise with the continuing global recession”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Suicidal ideation and suicide attempt are associated with increased health care costs, with up to one-third of patient admissions in psychiatric hospitals attributed to suicidal ideation or suicide attempt.

    “In addition, suicidal ideation and suicide attempt are associated with increased health care costs, with up to one-third of patient admissions in psychiatric hospitals attributed to suicidal ideation or suicide attempt 332 .”

    From Suicide and suicide risk (2019) · cites this paper as [332]

    The Results (Poor mental health; page unavailable) report that young suicide attempters were more likely than non-attempters to use mental-health services and to have been hospitalized for a psychiatric condition. The Methods (Measures; page unavailable) treats these outcomes as predictors of healthcare costs. The paper does not establish the claim for suicidal ideation, measure increased costs directly, or report that up to one-third of psychiatric hospital admissions are attributable to ideation or attempts. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Several factors are associated with reduced mental health components of quality of life assessments, such as being female, having borderline personality disorder or having high impulsivity, hopelessness or hostility.

    “In addition, several factors are associated with reduced mental health components of quality of life assessments, such as being female, having borderline personality disorder or having high impulsivity, hopelessness or hostility 332 .”

    From Suicide and suicide risk (2019) · cites this paper as [332]

    The Methods distinguish mental-health outcomes from quality-of-life outcomes, and the Results associate poorer outcomes with a history of youth suicide attempt. The Gender Differences section discusses physical functioning and metabolic syndrome, not a mental-health component of quality of life. Searches for borderline personality disorder, impulsivity, hopelessness, hostility, and the claimed quality-of-life association found no passage addressing those factors. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Diagnostic interview citation points to an unrelated reference

    Minor

    The text assigns reference 33 to the child diagnostic interview, but entry 33 is about youth employment rates, not that instrument.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. [35]Elley W The Elley-Irving Socio-Economic Index 1981 Census Revision New Zealand Journal of Educational Studies 1985 20 115 128
  2. [43]Link BG Phelan JC Conceptualizing stigma Annual Review of Sociology 2001 27 1 363 385

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Related

Authors
Goldman-Mellor, S. J., Caspi, A., Harrington, H., Hogan, S., Nada-Raja, S., Poulton, R., & Moffitt, T. E.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Duke University (US)
  • University of Otago (NZ)
  • Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
Corresponding author
Moffitt, Terrie E.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2014-02-01
Volume
71
Issue
2
Pages
119
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2013.2803
PMC
PMC3946312
OpenAlex
W2112628304
Cited by
310
References
42
Citations by year
2026: 12 · 2025: 29 · 2024: 29 · 2023: 28 · 2022: 26 · 2021: 30 · 2020: 26 · 2019: 30 · 2018: 32 · 2017: 18 · 2016: 18 · 2015: 21 · 2014: 10 · 2012: 1
FWCI
18.01
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
Funders
  • Jacobs Foundation (AG032282)
  • University of North Carolina at Chapel Hill (T32-HD07376)
  • Medical Research Council (MR/K00381X, MR/K00381X/1, AG032282)
  • National Institute on Aging (AG-032282, R01AG032282)
  • National Institute of Child Health and Human Development (AG032282)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD007376)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
Keywords
suicide attempts, youth, depression, substance dependence, physical health, metabolic syndrome, inflammation, violence, intimate partner violence, social support, welfare receipt, unemployment, loneliness, life satisfaction, global recession, suicide prevention, Dunedin Multidisciplinary Health and Development Study
MeSH terms
Adolescent, Adult, Mental Disorders, Female, Follow-Up Studies, Health Status, Humans, Long-Term Care, Male, Mental Health Services, New Zealand, Personal Satisfaction, Social Support, Suicide, Attempted, Violence, Comorbidity, Young Adult

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