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Zhang N, Smith IC, Ginsburg G. Do Self-Processes and Parenting Mediate the Effects of Anxious Parents' Psychopathology on Youth Depression and Suicidality? Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01657-z. [PMID: 38206536 DOI: 10.1007/s10578-023-01657-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Abstract
To understand how anxious parents' global psychopathology increases children's risks for depression and suicidality, we tested mediational pathways through which parent global psychopathology was associated with youth depression and suicidality over a six-year period. Parents (n = 136) who had an anxiety disorder at baseline reported global psychopathology and youth internalizing problems. Youth did not have any psychiatric disorder at baseline and they reported self-esteem, perceived control, and perceived parental warmth and rejection at baseline and 1-year follow-up. At 6-year follow-up, youth depression and suicidality were assessed via multiple reporters including the self, parent, and/or an independent evaluator. Results showed that parental psychopathology had an indirect but not direct effect on youth depression and suicidality via perceived control. No associations were found for the other hypothesized mediators. Perceived control might be a transdiagnostic intervention target in depression and suicide prevention programs for youth exposed to parental anxiety.
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Affiliation(s)
- Na Zhang
- Department of Human Development and Family Sciences, University of Connecticut, 1 University Place, Stamford, CT, 06901, USA.
| | - Isaac C Smith
- Hartford Hospital, Institute of Living, Hartford, CT, USA
- University of Vermont Medical Center, Burlington, VT, USA
| | - Golda Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
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2
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Ortin-Peralta A, Keski-Säntti M, Gissler M, Veijola J, Sourander A, Duarte CS. Parental suicide attempts and offspring's risk of attempting or dying by suicide: does the timing of a parental suicide attempt matter? Psychol Med 2023; 53:977-986. [PMID: 34140058 DOI: 10.1017/s0033291721002397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies on the transmission of suicide risk have focused on parental history of suicide attempts (SAs), overlooking when the attempt happened. This study examined how the offspring's risk of attempting or dying by suicide varied by the timing of a first parental SA and the sex of the parent who attempted suicide. METHODS Participants were 59 469 members of the 1987 Finnish Birth Cohort. The Finnish Hospital Discharge and Cause of Death Registers were the sources for parental and offspring SAs and offspring suicide. Timing of parental SA was coded as before (pre-pregnancy and pregnancy) and after the child's birth [infant/toddler years (0-2 years), childhood (3-11 years), adolescence (12-17 years), and young adulthood (18-26 years)]. RESULTS In the multivariate models, having a parent who attempted suicide increased the offspring's risk of attempting suicide (odds ratio (OR) = 1.77, 95% confidence interval (CI) 1.39-2.25), but not of dying by suicide. Compared to unexposed offspring, those exposed after child's birth were at higher risk of attempting suicide (OR = 1.90, 95% CI 1.46-2.47), specifically when the parent attempted during offspring's childhood, adolescence, and young adulthood. A first maternal SA increased offspring's risk of attempting suicide regardless of the timing. CONCLUSIONS The impact of a parental SA on offspring's risk of attempting suicide differed depending on the timing and sex of the parent who attempted suicide, suggesting that the transmission of suicide risk may occur through genetic as well as environmental factors. Our findings call for an intergenerational approach in suicide risk assessment.
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Affiliation(s)
- Ana Ortin-Peralta
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA
| | | | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Juha Veijola
- Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Cristiane S Duarte
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
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Khoubaeva D, Dimick M, Timmins VH, Fiksenbaum LM, Mitchell RHB, Schaffer A, Sinyor M, Goldstein BI. Clinical correlates of suicidality and self-injurious behaviour among Canadian adolescents with bipolar disorder. Eur Child Adolesc Psychiatry 2023; 32:41-51. [PMID: 34028609 DOI: 10.1007/s00787-021-01803-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 05/09/2021] [Indexed: 11/26/2022]
Abstract
There is high risk of suicidality in bipolar disorder (BD), particularly in early onset cases. The literature regarding correlates and putative predictors of suicide attempts (SA), non-suicidal self-injury (NSSI) and suicidal ideation (SI) among youth with BD remains sparse. Participants included 197 adolescents with BD, divided into 4 groups: SA (with or without NSSI), NSSI (with or without SI), SI only, and comparison group (CG; no SA/NSSI/SI). Diagnoses, treatment, and suicidality measures were determined via semi-structured interviews, conducted between 2009 and 2017. Univariate analyses were followed by multinomial regression. Overall, 73.6% of participants had history of SA, NSSI, and/or SI. In comparison to CG, SA and NSSI were each associated with BD-II/-NOS (odds ratio [OR] = 15.99, p = 0.002; OR = 16.76, p = 0.003), female sex (OR = 6.89, p = 0.006; OR = 3.76, p = 0.02), and emotion dysregulation (OR = 1.10, p < 0.001; OR = 1.07, p = 0.004). NSSI and SI were each associated with most severe lifetime depression (OR = 1.10, p = 0.01; OR = 1.10, p = 0.01). SA and SI were associated with psychiatric hospitalization (OR = 19.45, p = 0.001; OR = 6.09, p = 0.03). SA was associated with poorer global functioning at most severe episode (OR = 0.88, p = 0.008). NSSI was associated with not living with both natural parents (OR = 0.22, p = 0.009). Study limitations include cross-sectional and retrospective design, stringent cut-offs for SA and NSSI, and recruitment from a tertiary clinical setting. Three quarters of adolescents with BD have had suicidality and/or self-injury. SA and NSSI were most similar to one another, and most different from CG, supporting the broader construct of self-harm. Future research should address the gap in knowledge regarding how sex differences and neurobiology are associated with the observed clinical differences.
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Affiliation(s)
- Diana Khoubaeva
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
| | - Mikaela Dimick
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Vanessa H Timmins
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
| | | | - Rachel H B Mitchell
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Bégin V, Fontaine NMG, Vitaro F, Boivin M, Tremblay RE, Côté SM. Perinatal and early-life factors associated with stable and unstable trajectories of psychopathic traits across childhood. Psychol Med 2023; 53:379-387. [PMID: 33949301 DOI: 10.1017/s0033291721001586] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND This study aimed to identify perinatal and early-life factors associated with trajectories of psychopathic traits across childhood. METHODS Participants were 1631 children (51.5% girls) from the Quebec Longitudinal Study of Child Development. A wide range of perinatal and early-life factors were assessed from pregnancy to age 2.5 years using medical files and mothers' reports. Psychopathic traits were assessed via teachers' reports at ages 6, 7, 8, 10, and 12 years. Latent class growth analyses and multinomial logistic regressions controlling for child sex were conducted. Two-way interaction effects between perinatal/early-life factors and child sex were explored. RESULTS Four trajectories of psychopathic traits were identified: High-stable (4.48%), Increasing (8.77%), Decreasing (11.46%), and Low-stable (75.29%). A few perinatal factors and most child-level and family-level early-life factors significantly increased the odds of following the High-stable v. the Low-stable trajectory. Higher levels of psychotropic exposures during pregnancy, socioeconomic adversity, child's physical aggression, child's opposition, mother's depressive symptoms, and hostile parenting increased the likelihood of following the Increasing instead of the Low-stable trajectory. Higher socioeconomic adversity, mother's depressive symptoms, and inconsistent parenting were associated with membership to the High-stable instead of the Decreasing trajectory. Most associations were not moderated by child sex. CONCLUSIONS These results shed light on the perinatal and early-life factors that are associated with specific pathways of psychopathic traits during childhood and suggest that different factors could be targeted to prevent the exacerbation (v. low and stable levels) or the stability at high levels (v. attenuation) of these traits.
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Affiliation(s)
- Vincent Bégin
- School of Criminology, University of Montreal, Montreal, Canada
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
| | - Nathalie M G Fontaine
- School of Criminology, University of Montreal, Montreal, Canada
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
| | - Frank Vitaro
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
- School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Michel Boivin
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
- School of Psychology, Laval University, Quebec, Canada
| | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Canada
- Department of Pediatrics, University of Montreal, Montreal, Canada
- School of Public Health, Physiotherapy & Population Science, University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Quebec, Canada
- School of Public Health, University of Montreal, Montreal, Canada
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Orri M, Ahun MN, Naicker S, Besharati S, Richter LM. Childhood factors associated with suicidal ideation among South African youth: A 28-year longitudinal study of the Birth to Twenty Plus cohort. PLoS Med 2022; 19:e1003946. [PMID: 35290371 PMCID: PMC8923476 DOI: 10.1371/journal.pmed.1003946] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although early life factors are associated with increased suicide risk in youth, there is a dearth of research on these associations for individuals growing up in disadvantaged socioeconomic contexts, particularly in low- and middle-income countries (LMICs). We documented the association between individual, familial, and environmental factors in childhood with suicidal ideation among South African youth. METHODS AND FINDINGS We used data from 2,020 participants in the Birth to Twenty Plus (Bt20+) study, a South African cohort following children born in Soweto, Johannesburg from birth (1990) to age 28 years (2018). Suicidal ideation was self-reported at ages 14, 17, 22, and 28 years, and the primary outcome of interest was suicidal ideation reported at any age. We assessed individual, familial, and socioeconomic characteristics at childbirth and during infancy, adverse childhood experiences (ACEs) between ages 5 and 13 years, and externalizing and internalizing problems between 5 and 10 years. We estimated odds ratios (ORs) of suicidal ideation for individuals exposed to selected childhood factors using logistic regression. Lifetime suicidal ideation was reported by 469 (23.2%) participants, with a 1.7:1 female/male ratio. Suicidal ideation rates peaked at age 17 and decreased thereafter. Socioeconomic adversity, low birth weight, higher birth order (i.e., increase in the order of birth in the family: first, second, third, fourth, or later born child), ACEs, and childhood externalizing problems were associated with suicidal ideation, differently patterned among males and females. Socioeconomic adversity (OR 1.13, CI 1.01 to 1.27, P = 0.031) was significantly associated with suicidal ideation among males only, while birth weight (OR 1.20, CI 1.02 to 1.41, P = 0.03), ACEs (OR 1.11, CI 1.01 to 1.21, P = 0.030), and higher birth order (OR 1.15, CI 1.07 to 1.243, P < 0.001) were significantly associated with suicidal ideation among females only. Externalizing problems in childhood were significantly associated with suicidal ideation among both males (OR 1.23, 1.08 to 1.40, P = 0.002) and females (OR 1.16, CI 1.03 to 1.30, P = 0.011). Main limitations of the study are the high attrition rate (62% of the original sample was included in this analysis) and the heterogeneity in the measurements of suicidal ideation. CONCLUSIONS In this study from South Africa, we observed that early life social and environmental adversities as well as childhood externalizing problems are associated with increased risk of suicidal ideation during adolescence and early adulthood.
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Affiliation(s)
- Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada
- Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, Bordeaux, France
- * E-mail:
| | - Marilyn N. Ahun
- Department of Social and Preventive Medicine, Université de Montréal School of Public Health, Montréal, Canada
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Sara Naicker
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Sahba Besharati
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
- CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, Canada
| | - Linda M. Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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Tremblay RE. COVID-19 preventive interventions for high-risk pregnant women and preschool children: a rehearsal for the baby boomers’ old-age pandemic? CANADIAN JOURNAL OF PUBLIC HEALTH 2022; 113:61-66. [PMID: 35089592 PMCID: PMC8796605 DOI: 10.17269/s41997-021-00574-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/08/2021] [Indexed: 11/18/2022]
Abstract
A large research-based consensus was achieved over the past 30 years concerning the importance of prenatal and early childhood development: Preventive interventions are needed early in life because physical and psychological problems during pregnancy and early childhood often lead to serious physical, psychological, educational, and social problems throughout the life course. These problems are also transmitted to the next generation. The COVID-19 pandemic is likely to have increased the number of families who need these early-life preventive interventions. Without intensive support, children from high-risk families are likely to fail in school, to have serious physical and mental health problems, and to reproduce another generation of children with similar physical, cognitive, and mental health problems. We underline the need to: (1) assess the extent of the COVID-19 damage on pregnant women and on their spouses, as well as on the families with preschool children; (2) help service providers identify the state-of-the art services they should implement; (3) assess the implementation of these services; and (4) help service providers maintain highly effective interventions. For the next 20 to 30 years at least, governments will be under intense pressure to invest massively in the health and care of the baby boomers. We are thus facing abysmal health care and retirement costs for the next 3 decades. Governments should be pressured to substantially invest in the support of pregnant women and preschool children, rather than in the sustained quality of life of the aging baby boomers.
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Affiliation(s)
- Richard E Tremblay
- Departments of Pediatrics and Psychology, University of Montreal, Montreal, QC, Canada.
- School of Public Health, University College Dublin, Dublin, Ireland.
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Vidal-Ribas P, Govender T, Sundaram R, Perlis RH, Gilman SE. Prenatal origins of suicide mortality: A prospective cohort study in the United States. Transl Psychiatry 2022; 12:14. [PMID: 35013255 PMCID: PMC8748551 DOI: 10.1038/s41398-021-01777-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 12/01/2022] Open
Abstract
Most suicide research focuses on acute precipitants and is conducted in high-risk populations. Yet, vulnerability to suicide is likely established years prior to its occurrence. In this study, we aimed to investigate the risk of suicide mortality conferred by prenatal sociodemographic and pregnancy-related factors. Offspring of participants (N = 49,853) of the Collaborative Perinatal Project, a U.S. population-based cohort of pregnancies enrolled between 1959 and 1966, were linked to the U.S. National Death Index to determine their vital status by the end 2016. We examined associations between sociodemographic factors during pregnancy, pregnancy complications, labor and delivery complications, and neonatal complications with suicide death coded according to ICD-9/10 criteria. By the end of 2016, 3,555 participants had died. Of these, 288 (214 males, 74 females) died by suicide (incidence rate = 15.6 per 100,000 person-years, 95% Confidence Interval [CI] = 13.9-17.5). In adjusted models, male sex (Hazard Ratio [HR] = 2.98, CI: 2.26-3.93), White race (HR = 2.14, CI = 1.63-2.83), low parental education (HR = 2.23, CI = 1.38-3.62), manual parental occupation (HR = 1.38, CI = 1.05-1.82), being a younger sibling (HR = 1.52, CI = 1.10-2.11), higher rates of pregnancy complications (HR = 2.36, CI = 1.08-5.16), and smoking during pregnancy (HR = 1,28, CI = 0.99-1.66) were independently associated with suicide risk, whereas birth and neonatal complications were not. Consistent with the developmental origins of psychiatric disorders, vulnerability to suicide mortality is established early in development. Both sociodemographic and pregnancy factors play a role in this risk, which underscores the importance of considering life course approaches to suicide prevention, possibly including provision of high-quality prenatal care, and alleviating the socioeconomic burdens of mothers and families.
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Affiliation(s)
- Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Roy H Perlis
- Center for Quantitative Health, Center for Genomic Medicine and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Orri M, Pingault JB, Turecki G, Nuyt AM, Tremblay RE, Côté SM, Geoffroy MC. Contribution of birth weight to mental health, cognitive and socioeconomic outcomes: two-sample Mendelian randomisation. Br J Psychiatry 2021; 219:507-514. [PMID: 33583444 DOI: 10.1192/bjp.2021.15] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Low birth weight is associated with adult mental health, cognitive and socioeconomic problems. However, the causal nature of these associations remains difficult to establish owing to confounding. AIMS To estimate the contribution of birth weight to adult mental health, cognitive and socioeconomic outcomes using two-sample Mendelian randomisation, an instrumental variable approach strengthening causal inference. METHOD We used 48 independent single-nucleotide polymorphisms as genetic instruments for birth weight (genome-wide association studies' total sample: n = 264 498) and considered mental health (attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), schizophrenia, suicide attempt), cognitive (intelligence) and socioeconomic (educational attainment, income, social deprivation) outcomes. RESULTS We found evidence for a contribution of birth weight to ADHD (OR for 1 s.d. unit decrease (~464 g) in birth weight, 1.29; 95% CI 1.03-1.62), PTSD (OR = 1.69; 95% CI 1.06-2.71) and suicide attempt (OR = 1.39; 95% CI 1.05-1.84), as well as for intelligence (β = -0.07; 95% CI -0.13 to -0.02) and socioeconomic outcomes, i.e. educational attainment (β = -0.05; 95% CI -0.09 to -0.01), income (β = -0.08; 95% CI -0.15 to -0.02) and social deprivation (β = 0.08; 95% CI 0.03-0.13). However, no evidence was found for a contribution of birth weight to the other examined mental health outcomes. Results were consistent across a wide range of sensitivity analyses. CONCLUSIONS These findings support the hypothesis that birth weight could be an important element on the causal pathway to mental health, cognitive and socioeconomic outcomes.
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Affiliation(s)
- Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health Research Institute, Department of Psychiatry, McGill University, Montreal, Canada; and Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, France
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London; and Social Genetic and Developmental Psychiatry Centre, King's College London, UK
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health Research Institute, Department of Psychiatry, McGill University, Montreal, Canada
| | - Anne-Monique Nuyt
- Centre Hospitalier Universitaire Sainte-Justine Research Center, Department of Pediatrics, University of Montreal, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, University of Montreal, Canada; and School of Public Health, University College Dublin, Ireland
| | - Sylvana M Côté
- Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, France; and Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Canada
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Douglas Mental Health Research Institute, Department of Psychiatry, McGill University, Montreal; and Department of Education and Counselling Psychology, McGill University, Montreal, Canada
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Suicidal ideation and attempt in adolescents exposed to maternal smoking across pregnancy and childhood: A 20-year prospective cohort study. J Affect Disord 2021; 286:10-18. [PMID: 33652357 DOI: 10.1016/j.jad.2021.02.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Few studies investigated the association between maternal smoking during pregnancy and offspring suicide risk, none considering postnatal smoking exposure. We investigated associations between maternal smoking patterns during the pre- and postnatal periods and adolescent suicidal ideation and attempt. METHODS We identified longitudinal patterns of maternal smoking from the prenatal period to the end of childhood (children's age 12 years, 10 assessments) among participants in the Québec Longitudinal Study of Child Development (N = 1623). We estimated associations between maternal smoking patterns and offspring self-reported suicidal ideation and attempt (ages 13-20). Background confounding factors (e.g., socioeconomic, familial, mental health) were controlled using propensity score inverse-probability weighting (IPW). RESULTS Participants reporting suicidal ideation and attempt were 9.3% and 8.4%, respectively. We identified four maternal smoking patterns: non-smoking (66.5%), increasing (5.5%), decreasing (9.3%), persistent (18.5%). Children exposed to persistent (OR=2.92, CI=1.99-4.30) and increasing (OR=2.06, CI=1.13-3.74) maternal smoking were more likely to attempt suicide, compared to non-exposed children. Accounting for confounding factors using IPW fully explained the association between increasing smoking and suicide attempt (OR=0.95, CI=0.39-2.09) but only reduced the association between persistent exposure and suicide attempt (OR=2.30, CI=1.04-4.99). No increased suicide attempt risk was found for children of mothers with a decreased smoking pattern. We found no associations for suicidal ideation. LIMITATIONS Propensity score cannot account for unmeasured confounding factors; attrition limits generalizability. CONCLUSIONS Offspring of mothers who smoked persistently and heavily prenatally and postnatally were at increased risk of suicide attempt in adolescence. Future studies should elucidate biological and psychosocial mechanisms potentially at play in these associations.
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10
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Orri M, Boivin M, Chen C, Ahun MN, Geoffroy MC, Ouellet-Morin I, Tremblay RE, Côté SM. Cohort Profile: Quebec Longitudinal Study of Child Development (QLSCD). Soc Psychiatry Psychiatr Epidemiol 2021; 56:883-894. [PMID: 33185737 DOI: 10.1007/s00127-020-01972-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The Quebec Longitudinal Study of Child Development (QLSCD) was designed to examine the long-term associations of preschool physical, cognitive, social, and emotional development with biopsychosocial development across childhood, adolescence, and young adulthood. METHODS QLSCD is an ongoing prospective cohort including 2120 singletons born in 1997/1998 in the Canadian province of Quebec. So far, data have been collected annually or every 2 years from child ages 5 months to 21 years. The cohort currently includes 1245 participants. Data available include a range of environmental (e.g., family characteristics, child behaviour, educational attainment, mental health), biological (e.g., hair cortisol, genetic, epigenetic), and administrative data. RESULTS QLSCD has contributed to the understanding of children's psychosocial development, including the development of physical aggression and anxiety. QLSCD articles have advanced scientific knowledge on the influence of early childhood factors on childhood, adolescent, and young adult mental health, including the effect of participation in early childcare on cognitive and behavioural development, the developmental origins of adolescent and young adult mental health problems and suicide risk, and the development of interpersonal difficulties (e.g., peer victimisation) from preschool years to adolescence. CONCLUSION QLSCD has given major contributions to our understanding of the link between different aspects of child development and biopsychosocial development during the first two decades of life. Unique features include the presence of environmental, biological, and administrative data, long-term follow-up with frequent data collections, and use of data from multiple informants, including teachers, mothers, fathers, and the children themselves.
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Affiliation(s)
- Massimiliano Orri
- McGill Group for Suicide Studies, Department of Psychiatry, Department, Montreal, Douglas Mental Health University Institute, McGill University, Frank B. Common Pavilion, F-2101 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada
- Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, Bordeaux, France
| | - Michel Boivin
- School of Psychology, Université Laval, Quebec, QC, Canada
| | - Chelsea Chen
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | - Marilyn N Ahun
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 3050 Edouard Montpetit, Montreal, QC, H3T 1J7, Canada
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Department of Psychiatry, Department, Montreal, Douglas Mental Health University Institute, McGill University, Frank B. Common Pavilion, F-2101 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada
- Department of Education and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, University of Montreal, Montreal, QC, Canada
- School of Public Health, University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, Bordeaux, France.
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 3050 Edouard Montpetit, Montreal, QC, H3T 1J7, Canada.
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11
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Navarro MC, Ouellet-Morin I, Geoffroy MC, Boivin M, Tremblay RE, Côté SM, Orri M. Machine Learning Assessment of Early Life Factors Predicting Suicide Attempt in Adolescence or Young Adulthood. JAMA Netw Open 2021; 4:e211450. [PMID: 33710292 PMCID: PMC7955274 DOI: 10.1001/jamanetworkopen.2021.1450] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Although longitudinal studies have reported associations between early life factors (ie, in-utero/perinatal/infancy) and long-term suicidal behavior, they have concentrated on 1 or few selected factors, and established associations, but did not investigate if early-life factors predict suicidal behavior. OBJECTIVE To identify and evaluate the ability of early-life factors to predict suicide attempt in adolescents and young adults from the general population. DESIGN, SETTING, AND PARTICIPANTS This prognostic study used data from the Québec Longitudinal Study of Child Development, a population-based longitudinal study from Québec province, Canada. Participants were followed-up from birth to age 20 years. Random forest classification algorithms were developed to predict suicide attempt. To avoid overfitting, prediction performance indices were assessed across 50 randomly split subsamples, and then the mean was calculated. Data were analyzed from November 2019 to June 2020. EXPOSURES Factors considered in the analysis included 150 variables, spanning virtually all early life domains, including pregnancy and birth information; child, parents, and neighborhood characteristics; parenting and family functioning; parents' mental health; and child temperament, as assessed by mothers, fathers, and hospital birth records. MAIN OUTCOMES AND MEASURES The main outcome was self-reported suicide attempt by age 20 years. RESULTS Among 1623 included youths aged 20 years, 845 (52.1%) were female and 778 (47.9%) were male. Models show moderate prediction performance. The areas under the curve for the prediction of suicide attempt were 0.72 (95% CI, 0.71-0.73) for females and 0.62 (95% CI, 0.60-0.62) for males. The models showed low sensitivity (females, 0.50; males, 0.32), moderate positive predictive values (females, 0.60; males, 0.62), and good specificity (females, 0.76; males, 0.82) and negative predicted values (females, 0.75; males, 0.71). The most important factors contributing to the prediction included socioeconomic and demographic characteristics of the family (eg, mother and father education and age, socioeconomic status, neighborhood characteristics), parents' psychological state (specifically parents' antisocial behaviors) and parenting practices. Birth-related variables also contributed to the prediction of suicidal behavior (eg, prematurity). Sex differences were also identified, with family-related socioeconomic and demographic characteristics being the top factors for females and parents' antisocial behavior being the top factor for males. CONCLUSIONS AND RELEVANCE These findings suggest that early life factors contributed modestly to the prediction of suicidal behavior in adolescence and young adulthood. Although these factors may inform the understanding of the etiological processes of suicide, their utility in the long-term prediction of suicide attempt was limited.
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Affiliation(s)
- Marie C. Navarro
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
| | - Isabelle Ouellet-Morin
- School of Criminology, Research Center of the Montreal Mental Health University Institute, University of Montreal, Montreal, Canada
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Michel Boivin
- School of Psychology, University of Laval, Quebec City, Canada
| | - Richard E. Tremblay
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Department of Pediatrics and Psychology, University of Montreal, Montreal, Canada
| | - Sylvana M. Côté
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
| | - Massimiliano Orri
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
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