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Childhood externalizing, internalizing and comorbid problems: distinguishing young adults who think about suicide from those who attempt suicide

Published online by Cambridge University Press:  29 June 2021

Melissa Commisso ,
Caroline Temcheff ,
Massimiliano Orri ,
Martine Poirier ,
Marianne Lau ,
Sylvana Côté ,
Frank Vitaro ,
Gustavo Turecki ,
Richard Tremblay  and
Marie-Claude Geoffroy Open the ORCID record for Marie-Claude Geoffroy [Opens in a new window]
Melissa Commisso
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
Caroline Temcheff
Affiliation:
Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
Massimiliano Orri
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, France
Martine Poirier
Affiliation:
Department of Education, University of Rimouski, Quebec, Canada
Marianne Lau
Affiliation:
Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
Sylvana Côté
Affiliation:
Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, France Department of Social and Preventive Medicine, University of Montreal, Quebec, Canada CHU Ste-Justine Research Centre, Montreal, QC, Canada INSERM 1219 Bordeaux Population Health, France
Frank Vitaro
Affiliation:
Department of Psychoeducation, University of Montreal
Gustavo Turecki
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada
Richard Tremblay
Affiliation:
CHU Ste-Justine Research Centre, Montreal, QC, Canada Department of Psychology, University of Montreal, Montreal, Quebec, Canada
Marie-Claude Geoffroy*
Affiliation:
Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
*
Author for correspondence: Marie-Claude Geoffroy, E-mail: marie-claude.geoffroy@mcgill.ca
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Abstract

Background

While childhood externalizing, internalizing and comorbid problems have been associated with suicidal risk, little is known about their specific associations with suicidal ideation and attempts. We examined associations between childhood externalizing, internalizing and comorbid problems and suicidal ideation (without attempts) and attempts by early adulthood, in males and females.

Method

Participants were from the Quebec Longitudinal Study of Kindergarten Children, a population-based study of kindergarteners in Quebec from 1986 to 1988 and followed-up until 2005. We captured the co-development of teacher-rated externalizing and internalizing problems at age 6–12 using multitrajectories. Using the Diagnostic Interview Schedule administered at age 15 and 22, we identified individuals (1) who never experienced suicidal ideation/attempts, (2) experienced suicidal ideation but never attempted suicide and (3) attempted suicide.

Results

The identified profiles were no/low problems (45%), externalizing (29%), internalizing (11%) and comorbid problems (13%). After adjusting for socioeconomic and familial characteristics, children with externalizing (OR 2.00, CI 1.39–2.88), internalizing (OR 2.34, CI 1.51–3.64) and comorbid (OR 3.29, CI 2.05–5.29) problems were at higher risk of attempting suicide (v. non-suicidal) by age 22 than those with low/no problems. Females with comorbid problems were at higher risk of attempting suicide than females with one problem. Childhood problems were not associated with suicidal ideation. Externalizing (OR 2.01, CI 1.29–3.12) and comorbid problems (OR 2.28, CI 1.29–4.03) distinguished individuals who attempted suicide from those who thought about suicide without attempting.

Conclusion

Childhood externalizing problems alone or combined with internalizing problems were associated with suicide attempts, but not ideation (without attempts), suggesting that these problems confer a specific risk for suicide attempts.

Keywords

Child psychiatrycomorbiditydevelopmental psychiatryexternalizing probleminternalizing problemssuicide attemptssuicide ideation
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 3 , February 2023 , pp. 1030 - 1037
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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