The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors: Results from the World Mental Health International College Student Initiative

Andrea Miranda-Mendizabal; Catherine M. Musyoka; Siobhan O'Neill; Claudiu Cristian Papasteri; Jose A. Piqueras; Codruta A. Popescu; Charlene Rapsey; Kealagh Robinson; Tiscar Rodriguez-Jimenez; Damian Scarf; Oi Ling Siu; Dan Stein; Sascha Y. Struijs; Cristina Tomoiaga; Karla Patricia Valdés-García; Shelby Vereecke; Daniel Vigo; Angel Y Wang; Samuel Y S Wong; Ronald Kessler; WHO World Mental Health International College Student (WMH-ICS) collaborators

doi:10.1016/j.psychres.2025.116555

The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors: Results from the World Mental Health International College Student Initiative

Andrea Miranda-Mendizabal, Catherine M. Musyoka, Siobhan O'Neill, Claudiu Cristian Papasteri, Jose A. Piqueras, Codruta A. Popescu, Charlene Rapsey, Kealagh Robinson, Tiscar Rodriguez-Jimenez, Damian Scarf, Oi Ling Siu, Dan Stein, Sascha Y. Struijs, Cristina Tomoiaga, Karla Patricia Valdés-García, Shelby Vereecke, Daniel Vigo, Angel Y Wang, Samuel Y S Wong, Ronald KesslerWHO World Mental Health International College Student (WMH-ICS) collaborators

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

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Abstract

Objective
To investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students.

Method
Poisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes.

Results
Lifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4–7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5–7.7]), followed by MDx (RR range 1.3–3.0). Of the demographic subgroups, transgender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3–2.6]; ideation-to-attempt transition RR=1.5 [1.3–1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9–2.2]), major depressive disorder (RR=2.0 [1.9–2.1]), and bipolar disorder (RR=1.8 [1.6–2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3–1.7]), bipolar disorder (RR=1.4 [1.2–1.7]), and sexual abuse (RR=1.4 [1.2–1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0–1.8]).

Conclusion
CAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.

Original language	English
Article number	116555
Journal	Psychiatry research
Volume	350
Early online date	22 May 2025
DOIs	https://doi.org/10.1016/j.psychres.2025.116555
Publication status	Published online - 22 May 2025

Bibliographical note

Publisher Copyright:
© 2025 The Author(s)

Data Access Statement

The data analyzed in this study is subject to the following licenses/restrictions: The WMH-ICS data sharing agreement limits access of this data to members of the consortium. The participant data and statistical analysis plan used for this study are available upon reasonable request from the corresponding author (Jordi Alonso) as long as the main objective of the data sharing request is replicating the analysis and findings as reported in this paper.

Keywords

Suicide
self-injurious behavior
students
Mental health
Adverse childhood experiences
Prevalence
Risk factors
Students
Self-injurious behavior
Global Health
Suicide, Attempted - statistics & numerical data
Humans
Suicidal Ideation
Mental Disorders - epidemiology - psychology
Male
Universities
Young Adult
Adolescent
Adverse Childhood Experiences - statistics & numerical data
Female
Adult
Students - statistics & numerical data - psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.psychres.2025.116555Licence: CC BY

Published_VersionFinal published version, 1.12 MBLicence: CC BY

Cite this

Miranda-Mendizabal, A., Musyoka, C. M., O'Neill, S., Papasteri, C. C., Piqueras, J. A., Popescu, C. A., Rapsey, C., Robinson, K., Rodriguez-Jimenez, T., Scarf, D., Siu, O. L., Stein, D., Struijs, S. Y., Tomoiaga, C., Valdés-García, K. P., Vereecke, S., Vigo, D., Wang, A. Y., Wong, S. Y. S., ... WHO World Mental Health International College Student (WMH-ICS) collaborators (2025). The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors: Results from the World Mental Health International College Student Initiative. Psychiatry research, 350, Article 116555. Advance online publication. https://doi.org/10.1016/j.psychres.2025.116555

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title = "The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors: Results from the World Mental Health International College Student Initiative",

abstract = "ObjectiveTo investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students.MethodPoisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes.ResultsLifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4–7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5–7.7]), followed by MDx (RR range 1.3–3.0). Of the demographic subgroups, transgender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3–2.6]; ideation-to-attempt transition RR=1.5 [1.3–1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9–2.2]), major depressive disorder (RR=2.0 [1.9–2.1]), and bipolar disorder (RR=1.8 [1.6–2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3–1.7]), bipolar disorder (RR=1.4 [1.2–1.7]), and sexual abuse (RR=1.4 [1.2–1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0–1.8]).ConclusionCAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.",

keywords = "Suicide, self-injurious behavior, students, Mental health, Adverse childhood experiences, Prevalence, Risk factors, Students, Self-injurious behavior, Global Health, Suicide, Attempted - statistics & numerical data, Humans, Suicidal Ideation, Mental Disorders - epidemiology - psychology, Male, Universities, Young Adult, Adolescent, Adverse Childhood Experiences - statistics & numerical data, Female, Adult, Students - statistics & numerical data - psychology",

author = "Philippe Mortier and Xue Yang and Yasmin Altwaijri and Holdcraft, {Jacob A.} and Sue Lee and Sampson, {Nancy A} and Yesica Albor and Ahmad AlHadi and J Alonso and Al-Saud, {Nouf K.} and Claes Andersson and Lukoye Atwoli and Auerbach, {Randy P.} and Caroline Muaka and B{\'a}ez-Mansur, {Patricia M.} and Laura Ballester and Jason Bantjes and Harald Baumeister and Marcus Bendtsen and Corina Benjet and Berman, {Anne H} and Ronny Bruffaerts and Paula Carrasco and Chan, {Silver C.N.} and Irina Cohut and Couder, {Mar{\'i}a Anabell Covarrubias D{\'i}az} and Crockett, {Marcelo A.} and Pim Cuijpers and David, {Oana A.} and Dong Dong and Ebert, {David D.} and Jorge Gaete and Mireia F{\'e}lez-N{\'o}brega and Forero, {Carlos Garc{\'i}a} and Margalida Gili and Guti{\'e}rrez-Garc{\'i}a, {Raul A.} and Haro, {Josep Maria} and Penelope Hasking and Xanthe Hunt and Mathilde Husky and Florence Jaguga and Leontien Jansen and Langer, {{\'A}lvaro I.} and Yan Liu and Scarlett Mac-Ginty and Vania Mart{\'i}nez and Andre Mason and Muthoni Mathai and Margaret McLafferty and Andrea Miranda-Mendizabal and Elaine Murray and Musyoka, {Catherine M.} and Siobhan O'Neill and Papasteri, {Claudiu Cristian} and Piqueras, {Jose A.} and Popescu, {Codruta A.} and Charlene Rapsey and Kealagh Robinson and Tiscar Rodriguez-Jimenez and Damian Scarf and Siu, {Oi Ling} and Dan Stein and Struijs, {Sascha Y.} and Cristina Tomoiaga and Vald{\'e}s-Garc{\'i}a, {Karla Patricia} and Shelby Vereecke and Daniel Vigo and Wang, {Angel Y} and Wong, {Samuel Y S} and Ronald Kessler and {WHO World Mental Health International College Student (WMH-ICS) collaborators}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s)",

year = "2025",

month = may,

day = "22",

doi = "10.1016/j.psychres.2025.116555",

language = "English",

volume = "350",

journal = "Psychiatry research",

issn = "0165-1781",

publisher = "Elsevier Ireland Ltd",

}

Miranda-Mendizabal, A, Musyoka, CM, O'Neill, S, Papasteri, CC, Piqueras, JA, Popescu, CA, Rapsey, C, Robinson, K, Rodriguez-Jimenez, T, Scarf, D, Siu, OL, Stein, D, Struijs, SY, Tomoiaga, C, Valdés-García, KP, Vereecke, S, Vigo, D, Wang, AY, Wong, SYS, Kessler, R & WHO World Mental Health International College Student (WMH-ICS) collaborators 2025, 'The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors: Results from the World Mental Health International College Student Initiative', Psychiatry research, vol. 350, 116555. https://doi.org/10.1016/j.psychres.2025.116555

The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors: Results from the World Mental Health International College Student Initiative. / Miranda-Mendizabal, Andrea; Musyoka, Catherine M.; O'Neill, Siobhan et al.
In: Psychiatry research, Vol. 350, 116555, 01.08.2025.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors

T2 - Results from the World Mental Health International College Student Initiative

AU - Mortier, Philippe

AU - Yang, Xue

AU - Altwaijri, Yasmin

AU - Holdcraft, Jacob A.

AU - Lee, Sue

AU - Sampson, Nancy A

AU - Albor, Yesica

AU - AlHadi, Ahmad

AU - Alonso, J

AU - Al-Saud, Nouf K.

AU - Andersson, Claes

AU - Atwoli, Lukoye

AU - Auerbach, Randy P.

AU - Muaka, Caroline

AU - Báez-Mansur, Patricia M.

AU - Ballester, Laura

AU - Bantjes, Jason

AU - Baumeister, Harald

AU - Bendtsen, Marcus

AU - Benjet, Corina

AU - Berman, Anne H

AU - Bruffaerts, Ronny

AU - Carrasco, Paula

AU - Chan, Silver C.N.

AU - Cohut, Irina

AU - Couder, María Anabell Covarrubias Díaz

AU - Crockett, Marcelo A.

AU - Cuijpers, Pim

AU - David, Oana A.

AU - Dong, Dong

AU - Ebert, David D.

AU - Gaete, Jorge

AU - Félez-Nóbrega, Mireia

AU - Forero, Carlos García

AU - Gili, Margalida

AU - Gutiérrez-García, Raul A.

AU - Haro, Josep Maria

AU - Hasking, Penelope

AU - Hunt, Xanthe

AU - Husky, Mathilde

AU - Jaguga, Florence

AU - Jansen, Leontien

AU - Langer, Álvaro I.

AU - Liu, Yan

AU - Mac-Ginty, Scarlett

AU - Martínez, Vania

AU - Mason, Andre

AU - Mathai, Muthoni

AU - McLafferty, Margaret

AU - Miranda-Mendizabal, Andrea

AU - Murray, Elaine

AU - Musyoka, Catherine M.

AU - O'Neill, Siobhan

AU - Papasteri, Claudiu Cristian

AU - Piqueras, Jose A.

AU - Popescu, Codruta A.

AU - Rapsey, Charlene

AU - Robinson, Kealagh

AU - Rodriguez-Jimenez, Tiscar

AU - Scarf, Damian

AU - Siu, Oi Ling

AU - Stein, Dan

AU - Struijs, Sascha Y.

AU - Tomoiaga, Cristina

AU - Valdés-García, Karla Patricia

AU - Vereecke, Shelby

AU - Vigo, Daniel

AU - Wang, Angel Y

AU - Wong, Samuel Y S

AU - Kessler, Ronald

AU - WHO World Mental Health International College Student (WMH-ICS) collaborators

PY - 2025/5/22

Y1 - 2025/5/22

N2 - ObjectiveTo investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students.MethodPoisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes.ResultsLifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4–7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5–7.7]), followed by MDx (RR range 1.3–3.0). Of the demographic subgroups, transgender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3–2.6]; ideation-to-attempt transition RR=1.5 [1.3–1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9–2.2]), major depressive disorder (RR=2.0 [1.9–2.1]), and bipolar disorder (RR=1.8 [1.6–2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3–1.7]), bipolar disorder (RR=1.4 [1.2–1.7]), and sexual abuse (RR=1.4 [1.2–1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0–1.8]).ConclusionCAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.

AB - ObjectiveTo investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students.MethodPoisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes.ResultsLifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4–7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5–7.7]), followed by MDx (RR range 1.3–3.0). Of the demographic subgroups, transgender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3–2.6]; ideation-to-attempt transition RR=1.5 [1.3–1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9–2.2]), major depressive disorder (RR=2.0 [1.9–2.1]), and bipolar disorder (RR=1.8 [1.6–2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3–1.7]), bipolar disorder (RR=1.4 [1.2–1.7]), and sexual abuse (RR=1.4 [1.2–1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0–1.8]).ConclusionCAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.

KW - Suicide

KW - self-injurious behavior

KW - students

KW - Mental health

KW - Adverse childhood experiences

KW - Prevalence

KW - Risk factors

KW - Students

KW - Self-injurious behavior

KW - Global Health

KW - Suicide, Attempted - statistics & numerical data

KW - Humans

KW - Suicidal Ideation

KW - Mental Disorders - epidemiology - psychology

KW - Male

KW - Universities

KW - Young Adult

KW - Adolescent

KW - Adverse Childhood Experiences - statistics & numerical data

KW - Female

KW - Adult

KW - Students - statistics & numerical data - psychology

UR - http://dx.doi.org/10.1016/j.psychres.2025.116555

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U2 - 10.1016/j.psychres.2025.116555

DO - 10.1016/j.psychres.2025.116555

M3 - Article

C2 - 40450963

SN - 0165-1781

VL - 350

JO - Psychiatry research

JF - Psychiatry research

M1 - 116555

ER -

The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors: Results from the World Mental Health International College Student Initiative

Abstract

Bibliographical note

Data Access Statement

Keywords

UN SDGs

Access to Document

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Cite this