How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people
Objectives To inform suicide prevention policies and responses to youths at risk by investigating whether suicide risk is predicted by a summary measure of common mental distress (CMD (the p factor)) as well as by conventional psychopathological domains; to define the distribution of suicide risks o...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/5/e032494.full |
| _version_ | 1819290074242613248 |
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| author | Peter B Jones Peter Fonagy Edward T Bullmore Paul Wilkinson Ela Polek Sharon A S Neufeld Ian Goodyer Michelle St Clair Gita Prabhu Ray Dolan Jan Stochl |
| author_facet | Peter B Jones Peter Fonagy Edward T Bullmore Paul Wilkinson Ela Polek Sharon A S Neufeld Ian Goodyer Michelle St Clair Gita Prabhu Ray Dolan Jan Stochl |
| author_sort | Peter B Jones |
| collection | DOAJ |
| description | Objectives To inform suicide prevention policies and responses to youths at risk by investigating whether suicide risk is predicted by a summary measure of common mental distress (CMD (the p factor)) as well as by conventional psychopathological domains; to define the distribution of suicide risks over the population range of CMD; to test whether such distress mediates the medium-term persistence of suicide risks.Design Two independent population-based cohorts.Setting Population based in two UK centres.Participants Volunteers aged 14–24 years recruited from primary healthcare registers, schools and colleges, with advertisements to complete quotas in age-sex-strata. Cohort 1 is the Neuroscience in Psychiatry Network (n=2403); cohort 2 is the ROOTS sample (n=1074).Primary outcome measures Suicidal thoughts (ST) and non-suicidal self-injury (NSSI).Results We calculated a CMD score using confirmatory bifactor analysis and then used logistic regressions to determine adjusted associations between risks and CMD; curve fitting was used to examine the relative prevalence of STs and NSSI over the population distribution of CMD. We found a dose–response relationship between levels of CMD and risk of suicide. The majority of all subjects experiencing ST and NSSI (78% and 76% in cohort 1, and 66% and 71% in cohort 2) had CMD scores no more than 2 SDs above the population mean; higher scores indicated the highest risk but were, by definition, infrequent. Pathway mediation models showed that CMD mediated the longitudinal course of both ST and NSSI.Conclusions NSSI and ST in youths reflect CMD that also mediates their persistence. Universal prevention strategies reducing levels of CMD in the whole population without recourse to screening or measurement may prevent more suicides than approaches targeting youths with the most severe distress or with psychiatric disorders. |
| first_indexed | 2024-12-24T03:16:57Z |
| format | Article |
| id | doaj.art-6a9fe2f41dcc4d1fbd65260e023b2b72 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-12-24T03:16:57Z |
| publishDate | 2020-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-6a9fe2f41dcc4d1fbd65260e023b2b722022-12-21T17:17:35ZengBMJ Publishing GroupBMJ Open2044-60552020-05-0110510.1136/bmjopen-2019-032494How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young peoplePeter B Jones0Peter FonagyEdward T BullmorePaul WilkinsonEla Polek1Sharon A S Neufeld2Ian Goodyer3Michelle St Clair4Gita Prabhu5Ray Dolan6Jan Stochl74 Department of Psychiatry, University of Cambridge, Cambridge, UKPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UKPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UKPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UKPsychology, University of Bath, Bath, UKWellcome Centre for Human Neuroimaging, University College London, London, UKWellcome Centre for Human Neuroimaging, University College London, London, UKPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UKObjectives To inform suicide prevention policies and responses to youths at risk by investigating whether suicide risk is predicted by a summary measure of common mental distress (CMD (the p factor)) as well as by conventional psychopathological domains; to define the distribution of suicide risks over the population range of CMD; to test whether such distress mediates the medium-term persistence of suicide risks.Design Two independent population-based cohorts.Setting Population based in two UK centres.Participants Volunteers aged 14–24 years recruited from primary healthcare registers, schools and colleges, with advertisements to complete quotas in age-sex-strata. Cohort 1 is the Neuroscience in Psychiatry Network (n=2403); cohort 2 is the ROOTS sample (n=1074).Primary outcome measures Suicidal thoughts (ST) and non-suicidal self-injury (NSSI).Results We calculated a CMD score using confirmatory bifactor analysis and then used logistic regressions to determine adjusted associations between risks and CMD; curve fitting was used to examine the relative prevalence of STs and NSSI over the population distribution of CMD. We found a dose–response relationship between levels of CMD and risk of suicide. The majority of all subjects experiencing ST and NSSI (78% and 76% in cohort 1, and 66% and 71% in cohort 2) had CMD scores no more than 2 SDs above the population mean; higher scores indicated the highest risk but were, by definition, infrequent. Pathway mediation models showed that CMD mediated the longitudinal course of both ST and NSSI.Conclusions NSSI and ST in youths reflect CMD that also mediates their persistence. Universal prevention strategies reducing levels of CMD in the whole population without recourse to screening or measurement may prevent more suicides than approaches targeting youths with the most severe distress or with psychiatric disorders.https://bmjopen.bmj.com/content/10/5/e032494.full |
| spellingShingle | Peter B Jones Peter Fonagy Edward T Bullmore Paul Wilkinson Ela Polek Sharon A S Neufeld Ian Goodyer Michelle St Clair Gita Prabhu Ray Dolan Jan Stochl How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people BMJ Open |
| title | How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people |
| title_full | How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people |
| title_fullStr | How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people |
| title_full_unstemmed | How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people |
| title_short | How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people |
| title_sort | how do the prevalence and relative risk of non suicidal self injury and suicidal thoughts vary across the population distribution of common mental distress the p factor observational analyses replicated in two independent uk cohorts of young people |
| url | https://bmjopen.bmj.com/content/10/5/e032494.full |
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