A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder
Open accessAbstract
No longitudinal study has examined risk factors for future suicide attempts in major depressive disorder in a nationally representative sample. The objective of this study was to investigate baseline sociodemographic characteristics, comorbid mental disorders, specific depressive symptoms, and previous suicidal behavior as potential risk factors for suicide attempts at 3 years follow-up. Data came from the national epidemiologic survey on alcohol and related conditions (NESARC), a large nationally representative longitudinal survey of mental illness in adults [Wave 1 (2001-2002); Wave 2 (2004-2005) n=34,653]. Logistic regression examined associations between risk factors present at Wave 1 and suicide attempts at Wave 2 (n=169) among individuals with major depressive disorder at baseline assessment (n=6004). Risk factors for incident suicide attempts at Wave 2 (n=63) were identified among those with major depressive disorder at Wave 1 and no lifetime history of suicide attempts (n=5170). Results revealed specific comorbid anxiety, personality, and substance use disorders to be associated with incident suicide attempts at Wave 2. Comorbid borderline personality disorder was strongly associated with suicide attempts in all models. Several comorbid disorders were strongly associated with suicide attempts at Wave 2 even after adjusting for previous suicidal behavior, notably posttraumatic stress disorder (adjusted odds ratio (AOR)=2.20; 95% confidence interval (95% CI) 1.27-3.83) and dependent personality disorder (AOR=4.43; 95% CI 1.93-10.18). These findings suggest that mental illness comorbidity confers an increased risk of future suicide attempts in major depressive disorder that is not solely accounted for by past suicidal behavior.
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Results of prospective studies on the effect of anxiety disorders on suicidal ideation are mixed, with some confirming and some falsifying the effect.
“The role of anxiety in the development of SI is less clear, since results of prospective studies are mixed – some confirmed and some falsified the effect of anxiety disorders on SI (Abreu et al., 2018; Bolton et al., 2010; Oquendo et al., 2004).”
From Modelling suicide ideation from beep to beep: application of network analysis to ecological momentary assessment data (2019) · cites this paper as Bolton et al., 2010
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Self-citation
- Authors
- Bolton, J. M., Pagura, J., Enns, M. W., Grant, B., & Sareen, J.
- Affiliations
- University of Manitoba (CA)
- National Institutes of Health (US)
- Corresponding author
- Bolton, James M.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 44
- Issue
- 13
- Pages
- 817-826
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC2888712
- OpenAlex
- W2005583995
- Cited by
- 183
- References
- 56
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 8 · 2023: 15 · 2022: 5 · 2021: 16 · 2020: 8 · 2019: 9 · 2018: 9 · 2017: 18 · 2016: 9 · 2015: 16 · 2014: 16 · 2013: 12 · 2012: 19
- FWCI
- 12.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Canadian Institutes of Health Research (152348)
- National Institute on Alcohol Abuse and Alcoholism (Z01AA000449)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- suicide attempts, major depressive disorder, risk factors, comorbidities, borderline personality disorder, post-traumatic stress disorder, dependent personality disorder, anxiety disorders, substance use disorders, personality disorders, depressive symptoms, sociodemographic factors
- MeSH terms
- Adult, Aged, Anxiety, Borderline Personality Disorder, Canada, Dependent Personality Disorder, Major Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, Stress Disorders, Post-Traumatic, Suicide, Attempted, Time Factors, Comorbidity, Confidence Intervals, Odds Ratio, Substance-Related Disorders, Young Adult
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