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J Clin Psychiatry. 2017 Jul;78(7):e828-e836. doi: 10.4088/JCP.17m11485.

A Risk Algorithm for the Persistence of Suicidal Thoughts and Behaviors During College.

Author information

1
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Herestraat 49, Leuven, Belgium. philippe.mortier@uzleuven.be.
2
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.
3
Department of Psychiatry, Harvard Medical School, Boston; and Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts, USA.
4
Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
5
School of Education, Boston University, Boston, Massachusetts, USA.
6
Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, Massachusetts, USA.
7
Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.

Abstract

OBJECTIVE:

The primary aims of this study are to (a) identify patterns of suicidal thoughts and behaviors (STB) during college among students with lifetime pre-matriculation STB and (b) develop a risk-screening algorithm for persistence of pre-matriculation STB during college.

METHODS:

Data come from the Leuven College Surveys, a series of prospective cohort studies of all incoming KU Leuven University freshmen. In the academic year 2012-2013, 4,889 incoming freshmen (73.2% response rate) provided baseline data on sociodemographic variables, childhood-adolescent traumatic experiences, 12-month stressful experiences, 12-month mental disorders, 12-month STB, and severity markers of pre-matriculation STB. A total of 2,566 students (69.3% conditional response rate) participated in 12- and 24-month follow-up surveys during the first 2 college years.

RESULTS:

Thirteen percent (weighted n = 535) of incoming freshmen reported lifetime pre-matriculation STB. Of those, 28.0% reported 12-month STB in 1 follow-up assessment, and another 27.7%, in both follow-up assessments. High persistence of STB (ie, 12-month STB in 2 follow-up assessments) was most strongly associated with severity markers of pre-matriculation STB, with odds ratios in the 2.4-10.3 range and population attributable risk proportions between 9.2% and 50.8%. When the aim was for less than 50% of false-positive cases (positive predictive value = 54.4%), a multivariate predictive risk algorithm (cross-validated area under the curve = 0.79) situated 59.9% of highly persistent cases among the 30% respondents with highest baseline predicted risk.

CONCLUSIONS:

An individualized web-based screening approach is a promising strategy to identify students at the time of university entrance who may be at high risk for STB persistence during their academic career.

PMID:
28640991
PMCID:
PMC5664942
DOI:
10.4088/JCP.17m11485
[Indexed for MEDLINE]
Free PMC Article

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