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Prediction of suicide attempt in a Swedish population-based cohort

Lannoy, Séverine ; Ohlsson, Henrik LU ; Stephenson, Mallory ; Kendler, Kenneth S. ; Sundquist, Jan LU ; Sundquist, Kristina LU and Edwards, Alexis C. LU (2025) In Acta Psychiatrica Scandinavica 151(1). p.92-101
Abstract

Background: Suicidal behaviors are prevalent public health concerns, and we need to improve our predictive ability to better inform prevention efforts. Methods: Using nationwide longitudinal Swedish registers, we included 344,490 males and 323,177 females born 1982–1990 with information on genetic liability and environmental exposures from birth to age 16: perinatal variables, parental psychopathology (suicide attempt, substance use disorder, major depression), family status, socioeconomic difficulties, peers' psychopathology, and school grades. We conducted sex-specific analysis and developed data-driven predictive models including risk factors that occurred between ages 0 and 16 using structural equation modeling. Results: In both... (More)

Background: Suicidal behaviors are prevalent public health concerns, and we need to improve our predictive ability to better inform prevention efforts. Methods: Using nationwide longitudinal Swedish registers, we included 344,490 males and 323,177 females born 1982–1990 with information on genetic liability and environmental exposures from birth to age 16: perinatal variables, parental psychopathology (suicide attempt, substance use disorder, major depression), family status, socioeconomic difficulties, peers' psychopathology, and school grades. We conducted sex-specific analysis and developed data-driven predictive models including risk factors that occurred between ages 0 and 16 using structural equation modeling. Results: In both females and males, the best-fitting models reveal a complex risk pathway to suicide attempt. In females, the model indicates four direct effects on suicide attempt risk: the occurrence of suicide attempt in parents during childhood (β = 0.159, 95% CI: 0.118; 0.199) and adolescence (β = 0.115, 95% CI: 0.077; 0.153), suicide attempt in peers (β = 0.068, 95% CI: 0.057; 0.079), and low academic achievement (β = 0.166, 95% CI: 0.156; 0.175). In males, aggregate genetic liability for suicide attempt (β = 0.130, 95% CI: 0.111; 0.148), suicide attempt in parents during adolescence (β = 0.099, 95% CI: 0.074; 0.124), suicide attempt in peers (β = 0.118, 95% CI: 0.108; 0.129), and low academic achievement (β = 0.61, 95% CI: 0.152; 0.171) were related to later suicide attempt. These factors also acted as mediators to explain the association between environmental exposures in childhood and later suicide attempt. Conclusions: These findings illustrate sex-specific pathways to suicide attempt by including risk factors that occur during the development. Results highlight the importance of genetic and family environment but also the prominent role of academic achievement.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
academic achievement, family genetic risk, psychopathology, suicide attempt
in
Acta Psychiatrica Scandinavica
volume
151
issue
1
pages
92 - 101
publisher
Wiley-Blackwell
external identifiers
  • pmid:39314120
  • scopus:85204716082
ISSN
0001-690X
DOI
10.1111/acps.13761
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 The Author(s). Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
id
2e5bd586-dac6-4a3d-ba6f-9a7b14e40580
date added to LUP
2024-12-03 11:19:18
date last changed
2025-07-02 04:50:26
@article{2e5bd586-dac6-4a3d-ba6f-9a7b14e40580,
  abstract     = {{<p>Background: Suicidal behaviors are prevalent public health concerns, and we need to improve our predictive ability to better inform prevention efforts. Methods: Using nationwide longitudinal Swedish registers, we included 344,490 males and 323,177 females born 1982–1990 with information on genetic liability and environmental exposures from birth to age 16: perinatal variables, parental psychopathology (suicide attempt, substance use disorder, major depression), family status, socioeconomic difficulties, peers' psychopathology, and school grades. We conducted sex-specific analysis and developed data-driven predictive models including risk factors that occurred between ages 0 and 16 using structural equation modeling. Results: In both females and males, the best-fitting models reveal a complex risk pathway to suicide attempt. In females, the model indicates four direct effects on suicide attempt risk: the occurrence of suicide attempt in parents during childhood (β = 0.159, 95% CI: 0.118; 0.199) and adolescence (β = 0.115, 95% CI: 0.077; 0.153), suicide attempt in peers (β = 0.068, 95% CI: 0.057; 0.079), and low academic achievement (β = 0.166, 95% CI: 0.156; 0.175). In males, aggregate genetic liability for suicide attempt (β = 0.130, 95% CI: 0.111; 0.148), suicide attempt in parents during adolescence (β = 0.099, 95% CI: 0.074; 0.124), suicide attempt in peers (β = 0.118, 95% CI: 0.108; 0.129), and low academic achievement (β = 0.61, 95% CI: 0.152; 0.171) were related to later suicide attempt. These factors also acted as mediators to explain the association between environmental exposures in childhood and later suicide attempt. Conclusions: These findings illustrate sex-specific pathways to suicide attempt by including risk factors that occur during the development. Results highlight the importance of genetic and family environment but also the prominent role of academic achievement.</p>}},
  author       = {{Lannoy, Séverine and Ohlsson, Henrik and Stephenson, Mallory and Kendler, Kenneth S. and Sundquist, Jan and Sundquist, Kristina and Edwards, Alexis C.}},
  issn         = {{0001-690X}},
  keywords     = {{academic achievement; family genetic risk; psychopathology; suicide attempt}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{92--101}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Psychiatrica Scandinavica}},
  title        = {{Prediction of suicide attempt in a Swedish population-based cohort}},
  url          = {{http://dx.doi.org/10.1111/acps.13761}},
  doi          = {{10.1111/acps.13761}},
  volume       = {{151}},
  year         = {{2025}},
}