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Chronic medical conditions and suicidal behaviors in a nationally representative sample of American adolescents

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Abstract

Purpose

Chronic medical conditions are a risk factor for the onset of suicidal thoughts and behaviors in adults. However, few studies have examined this association in adolescents. The present study explored the association between chronic medical conditions and the emergence of suicidal thoughts and behaviors in an adolescent sample representative of the U.S.A. population.

Method

Using data from the National Comorbidity Survey—Adolescent Supplement (10,148 Americans between ages 13–17), discrete-time survival analyses were performed to examine the odds of developing suicidal ideation, planning, and attempts, given prior presence of a chronic medical condition. Multivariate models controlled for sociodemographic factors and the presence of comorbid mental health conditions. Post-hoc sensitivity analyses examined associations between timing of chronic medical condition onset and later suicidal thoughts and behaviors.

Results

Multivariate analyses showed that dermatological conditions, asthma, allergies, headache, and back/neck pain were associated with elevated odds of suicidal ideation, while cardiovascular conditions were associated with increased odds of suicide attempts. Additionally, cardiovascular conditions were associated with increased risk of suicide planning and attempts among adolescents with suicidal ideation. Chronic medical conditions that began in adolescence were associated with the greatest risk of later suicidal thoughts and behaviors, compared to chronic medical conditions that began in early or middle childhood.

Conclusion

Consistent with research in middle and older adults, physical health conditions are associated with increased risk for the onset of suicidal thoughts and behaviors in adolescents. Mental health screening for adolescents with chronic medical conditions may help parents and physicians identify suicidality early.

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Acknowledgements

The National Comorbidity Survey Replication Adolescent Supplement (NCS-A) was supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044,780), and the John W. Alden Trust. The work of the authors (Dean-Boucher, Robillard, and Turner) was not supported by any additional funding source. The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. Government.

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Authors and Affiliations

  1. Department of Psychology, University of Victoria, P. O. Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada

    Anthony Dean-Boucher, Christina L. Robillard & Brianna J. Turner

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  1. Anthony Dean-Boucher
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  2. Christina L. Robillard
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  3. Brianna J. Turner
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Correspondence to Brianna J. Turner.

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Dean-Boucher, A., Robillard, C.L. & Turner, B.J. Chronic medical conditions and suicidal behaviors in a nationally representative sample of American adolescents. Soc Psychiatry Psychiatr Epidemiol 55, 329–337 (2020). https://doi.org/10.1007/s00127-019-01770-2

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