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Archives of Public Health

Volume 73 Supplement 1

Methods in Epidemiology Symposium

Open Access

Individual- and population-level effects of childhood adversity and emotional problems on early-onset suicide plans and/or attempt(s)

  • Philippe Mortier1,
  • K Demyttenaere2,
  • RP Auerbach3,
  • JG Green4,
  • RC Kessler5,
  • G Kiekens2,
  • MK Nock6 and
  • R Bruffaerts2
Archives of Public HealthThe official journal of the Belgian Public Health Association201573(Suppl 1):P39

Published: 17 September 2015


Childhood adversity and emotional problems are strong and potentially modifiable predictors for early-onset severe suicidal thoughts and behaviors (STB).


To identify individual-level and population-level risk factors for STB in young people.


Web-based selfreport data from incoming KULeuven freshmen (n=4,921; RR=65.4%) were used to calculate multivariate odds ratios (OR), and multivariate population attributable risk proportions (PARP) for the association between lifetime suicide plans and/or attempt(s) on the one, and six types of childhood adversity and 6 types of emotional problems on the other hand.


Lifetime prevalence (P) of suicide plans and/or attempt(s) was 6.9% (SE=0.3) with an average age of onset of 14.3 years (SE=0.2; SD = 2.5). Multivariate associations were found with frequent victimization of childhood abuse at home (p=3.4%; SE=0.3; OR=3.8; PARP=10.4%), frequent childhood bully victimization (p=10.1%; SE=0.5; OR=2.4; PARP=13.5%), lifetime risk for internalizing disorders (p=37.0%; SE=0.5; OR=6.5; PARP=65.7%), one or more eating disorder symptoms (p=12.0%; SE=0.3; OR=2.6; PARP=15.5%), and one or more psychotic symptoms (p=7.5%; SE=0.3; OR=3.3; PARP=12.0%).


The cross-sectional study design precludes causal inference, and college student findings may not be fully representative for early-onset STB among the general population.


Early-onset STB is mostly attributable to proximal risk factors such as internalizing mental disorders, eating disorders, and psychotic symptoms. However, distal risk factors like bully victimization and childhood abuse also play a considerable role in the onset of STB among young people. In terms of prevention, our data suggest that resources should preferably be allocated to the early detection of internalizing disorders.

Authors’ Affiliations

KULeuven, Leuven, Belgium
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
Harvard Medical School; McLean Hospital, Center for Depression, Anxiety and Stre, Belmont, USA
School of Education, Boston University, Boston, USA
Harvard Medical School, Department of Health Care Policy, Harvard University, Cambridge, USA
Department of Psychology, Harvard University, Cambridge, USA


© Mortier et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.