Prenatal and childhood antecedents of suicide: 50-year follow-up of the 1958 British Birth Cohort Study. Issue 6 (April 2014)

• Record Type: Journal Article
• Authors: Geoffroy, M.-C.; Gunnell, D.; Power, C.
• Is Part Of: Psychological medicine. Volume 44:Issue 6(2014)
• Page Start: 1245
• Page End: 1256
• Publication Date: 2014-04
• Subjects: Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S003329171300189X
• Languages: English
• ISSNs: 0033-2917

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="sec_a1"> <title>Background</title> <p>We aimed to elucidate early antecedents of suicide including possible mediation by early child development.</p> </sec> <sec id="sec_a2" sec-type="methods"> <title>Method</title> <p>Using the 1958 birth cohort, based on British births in March 1958, individuals were followed up to adulthood. We used data collected at birth and at age 7 years from various informants. Suicides occurring up to 31 May 2009 were identified from linked national death certificates. Multivariable Cox proportional hazard models were used to investigate risk factors.</p> </sec> <sec id="sec_a3" sec-type="results"> <title>Results</title> <p>Altogether 12399 participants (<italic>n</italic> = 44 suicides) had complete data. The strongest prenatal risk factors for suicide were: birth order, with risk increasing in later-born children [<italic>p</italic><sub>trend</sub> = 0.063, adjusted hazard ratio (HR)], e.g. for fourth- or later-born children [HR = 2.27, 95% confidence interval (CI) 0.90–5.75]; young maternal age (HR = 1.18, 95% CI 0.34–4.13 for ⩽19 years and HR = 0.41, 95% CI 0.19–0.91 for >29 years, <italic>p</italic><sub>trend</sub> = 0.034); and low (<2.5 kg) birth weight (HR = 2.48, 95% CI 1.03–5.95). The strongest risk factors at 7 years were externalizing problems in males (HR = 2.96, 95% CI 1.03–8.47, <italic>p</italic><sub>trend</sub> = 0.050) and number of emotional adversities (i.e. parental death, neglected appearance, domestic tension, institutional care, contact with social services, parental divorce/separation and bullying) for which there was a graded association with risk of suicide (<italic>p</italic><sub>trend</sub> = 0.033); the highest (HR = 3.12, 95% CI 1.01–9.62) was for persons with three or more adversities.</p> </sec> <sec id="sec_a4" sec-type="conclusion"> <title>Conclusions</title> <p>Risk factors recorded at birth and at 7 years may influence an individual's long-term risk of suicide, suggesting that trajectories leading to suicide have roots in early life. Some factors are amenable to intervention, but for others a better understanding of causal mechanisms may provide new insights for intervention to reduce suicide risk.</p> </sec> </abstract>