Antti Haavisto

Childhood Predictors of Completed and Severe Suicide Attempts: Findings From the Finnish 1981 Birth Cohort Study

CONTEXT To our knowledge, no prospective, population-based study in existence examines predictive associations between early or middle childhood psychopathologic disorders and later completed suicides. OBJECTIVE To study predictive associations between childhood psychopathologic disorders at the age of 8 years and later completed suicides and severe suicide attempts. DESIGN Birth cohort study of individuals 8 to 24 years old. SETTING Finland. PARTICIPANTS The sample includes 5302 Finnish people born in 1981 who were examined at the age of 8 years to gather information about psychopathologic conditions, school performance, and family demographics from parents, teachers, and children. MAIN OUTCOME MEASURES National register-based lifetime information about completed suicides and suicide attempts that prompted hospital admission. RESULTS Of all 24 deaths among males between 8 and 24 years of age, 13 were suicides, whereas of 16 deaths among females, only 2 were suicides. Fifty-four males and females (1%) had either completed suicide or made a serious suicide attempt, defined as a suicide attempt that prompted hospital admission. Of 27 males with completed or serious suicide attempts, 78% screened positive on parent or teacher Rutter scales at the age of 8 years, whereas of 27 females only 11% screened positive. Among males, completed or serious suicide attempt outcome was predicted at the age of 8 years by living in a nonintact family; psychological problems as reported by the primary teacher; or conduct, hyperkinetic, and emotional problems. However, self-reports of depressive symptoms at the age of 8 years did not predict suicide outcome. No predictive associations between the study variables measured at the age of 8 years and suicide outcome were found among females. Male suicide outcome was predicted most strongly by comorbid conduct and internalizing problems. CONCLUSIONS Most males who completed suicide and/or made serious suicide attempts in adolescence or early adulthood had psychiatric problems by the age of 8 years, indicating a trajectory that persists throughout their lives. However, female severe suicidality is not predicted by psychopathologic disorders at the age of 8 years. The results give additional support to the importance of early detection and treatment of psychiatric problems in males.

Suicidal thoughts and attempts among adolescents: a longitudinal 8-year follow-up study

BACKGROUND To study the prevalence of and factors associated with suicidal behaviour among 580 adolescents. METHODS An 8-year longitudinal study included questions about suicidal attempts and thoughts at age 16. Children were evaluated with parent and teacher Rutter scales and self-reported Child Depression Inventory at age 8. At age 16, parents filled in the Child Behaviour Check List and adolescents the Youth Self Report. RESULTS 14% of girls and 7% of boys reported suicidal thoughts or preoccupations at age 16. Emotional and behavioural problems at age 8, especially antisocial symptoms, reported by parents and teachers and depressive symptoms reported by the child were correlated with suicidal thoughts and behaviour 8 years later. At age 16, internalizing and externalizing problems and low social competence were associated with suicidal features. Only about 20% of those who reported suicidal features had been referred to child mental health services. CONCLUSIONS Many adolescents with suicidal thoughts and behaviour had a high rate of behavioural and emotional problems already at age 8. CLINICAL IMPLICATIONS The early school years represent an opportunity for interventions which may prevent self-destructive behaviours in adolescence.

Military fitness class of Finnish 18-year-old men--prediction of military fitness class at call-up with the YASR and sociodemographic factors.

ObjectiveThe aim of this study was to examine psychosocial factors associated with military fitness class, classified as capability of service, vs. temporary or permanent exemption from service.MethodParticipants were 2,340 (80% of the original sample) Finnish 18-year-old men at call-up for obligatory military service who filled in the Young Adult Self-Report (YASR) questionnaire.ResultsTemporary exemption from military service was independently associated with the YASR total problem score, externalizing and internalizing problems, excessive alcohol use, drug use, problems with peers and family, and mental health service use.Permanent exemption was independently associated with problems with peers and family.ConclusionThe YASR is a potential selection tool to be used at call-up. Temporary exemption was more strongly associated with psychosocial problems than permanent exemption. Because of the high level of psychological problems among those temporarily exempted, the call-up situation offers a unique opportunity to identify those with problem behaviour and risk of marginalization.

Factors associated with reported childhood depressive symptoms at age 8 and later self-reported depressive symptoms among boys at age 18.

AimsThis study aimed to study conditions associated with depressive symptoms at ages 8 and 18 in a representative birth cohort of Finnish males.MethodsThe participants in this community-based 10-year follow-up study consisted of 2,348 boys born in 1981. At age 8, three informant sources were used: parents, teachers, and the children themselves. Depressive symptoms were established using the Children’s Depression Inventory (CDI). At age 18, self-report questionnaires were used to study the boys’ family factors, life events, adaptive functioning, and substance use. Depressive symptoms at age 18 were established using Beck’s Depression Inventory (BDI).ResultsPoor adaptive functioning at age 18 was independently associated with both child and late adolescent depressive symptoms. Use of illicit drugs and somatic health problems were independently associated with later depressive symptoms. Parental divorce in early childhood independently predicted depressive symptoms both in childhood and in late adolescence. Teacher reports of child’s total problems at age 8 independently predicted depressive symptoms at age 18.ConclusionsDepression in males at ages 8 and 18 is particularly associated with stressful life events in childhood, whereas late depression is associated with somatic health problems and substance use. Further population-based studies comparing conditions associated with childhood and adolescent depression are needed.