Adult Associations of Childhood Suicidal Thoughts and Behaviors: A Prospective, Longitudinal Analysis

J Am Acad Child Adolesc Psychiatry. 2017 Nov;56(11):958-965.e4. doi: 10.1016/j.jaac.2017.08.015. Epub 2017 Sep 15.


Objective: Suicidal thoughts and behavior (STBs) have their peak period of onset in adolescence, but little is known about how such behavior is associated with later functioning. The aim of this study is to test whether childhood STBs are related to adult psychiatric, suicidal, and functional outcomes.

Method: This is a prospective, population-based community study of 1,420 participants assessed with structured interviews up to 7 times in childhood/adolescence (ages 9-16 years; 6,674 observations) for STBs including passive and active ideation, plans, and attempts. Participants were then assessed 4 times in young adulthood (ages 19, 21, 24, and 30 years; 4,556 observations of 1,273 participants) for psychiatric diagnoses, STBs, and functional outcomes.

Results: By age 16 years, 7.0% of participants had reported some type of STBs, with 3.9% reporting an attempt. Both ideation only and suicide attempts were associated with higher levels of anxiety disorders and STBs in adulthood, as well as poor functioning across financial, health, risky/illegal, and social domains. These observed effects generally were attenuated after adjusting for other psychiatric and psychosocial factors that predict childhood STBs (particularly maltreatment, depression, and disruptive behavior disorders). The exception was adult suicidal behavior, which was predicted by both childhood ideation and attempts, even in the fully adjusted model. Children and adolescents with STBs were more likely to have had a disrupted transition to adulthood.

Conclusion: Childhood STBs are a marker for a multitude of poor psychiatric and functional outcomes in adulthood, but these effects are largely accounted for by other factors. In contrast, childhood STBs are a robust risk factor for adult suicidal thoughts and behavior.

Keywords: childhood; epidemiology; longitudinal; suicidal behavior; suicide.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders / epidemiology*
  • Child
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Suicidal Ideation*
  • Suicide, Attempted / statistics & numerical data*
  • Young Adult