BACKGROUND: Obtaining recent estimates of the prevalence of suicide-related outcomes across adolescence and its associated mental health problems (MHPs) is important for clinical practice. We estimated the prevalence of suicide-related outcomes at ages 13, 15, 17, and 20 years (2011-2018) in a contemporary population-based cohort and documented associations with MHPs throughout adolescence. METHODS: Data came from 1618 participants in the Québec Longitudinal Study of Child Development. Internalizing (depression and anxiety) and externalizing (oppositional/ defiance, conduct issues, and attention deficit and/or hyperactivity) MHPs were assessed with validated questionnaires. Outcomes were self-reported past-year passive and serious suicidal ideation and suicide attempt. RESULTS: Lifetime prevalence of passive suicidal ideation (13-17 years old), serious suicidal ideation, and suicide attempt (13-20 years old) were 22.2%, 9.8%, and 6.7%, respectively. Prevalence was twice as high for females as for males. Overall, rates of passive (15-17 years old; 11.8%-18.4%) and serious ideation (13-20 years old; 3.3%-9.5%) increased over time but were stable for attempt (13-20 years old; 3.5%-3.8%). In univariable analyses, all MHPs were associated with suicide-related outcomes at all ages (risk rate ratio range: 2.57-3.10 [passive ideation] and 2.10-4.36 [suicide attempt]), and associations were similar for male and female participants (sex interaction P. .05). Magnitude of associations were generally stronger for more severe suicide-related outcomes (passive ideation , serious ideation , attempt). In multivariable analyses, internalizing problems were associated with suicidal ideation, whereas both depressive and conduct symptoms were associated with attempt. CONCLUSIONS: Suicidal ideation and attempt were common, especially for females and youth presenting with depressive and conduct problem symptoms. Clinicians should systematically assess suicidal risk in teenagers, especially in those presenting with MHPs. WHAT'S KNOWN ON THIS SUBJECT: Suicide-related outcomes are associated with a range of mental health problems (MHPs) in adolescence, but the importance of different internalizing and externalizing MHPs may vary across adolescence and for different suicide-related outcomes (passive ideation, serious ideation, and suicide attempt). WHAT THIS STUDY ADDS: Suicide-related outcomes are common in adolescence, with stable rates of suicide attempt and increasing rates of suicidal ideation. Internalizing MHPs are independently associated with suicidal ideation (passive and serious), whereas externalizing and internalizing MHPs are independently associated with suicide attempt.

In-utero and perinatal influences on suicide risk: a systematic review and meta-analysis Summary Background. Adverse in-utero and perinatal conditions may contribute to a heightened suicide risk throughout the lifespan, however existing evidence is sparse and contradictory. We did a systematic review and meta-analysis to investigate in-utero and perinatal exposures associated with suicide, suicide attempt, and suicidal ideation. Methods. We searched MEDLINE, Embase, and PsycINFO from inception to January 24, 2019 for population-based prospective studies investigating the association between in-utero and perinatal factors and suicide, suicide attempt, and suicidal ideation. We calculated pooled odds ratio (ORs) with 95% CIs using random-effects models and used meta-regression to investigate heterogeneity. Findings. We identified 42 studies; they had a low risk of bias (median quality score 9/9; range 5-9). Family/parental characteristics, such as high birth order (eg, pooled ORs fourth or later born vs first born 1.

Background: To clarify the direction of the association between frequency of cannabis use, depressive symptoms and suicidal ideation from 15 to 20 years using cross-lagged analyses. Method:We included 1606 adolescents from the province of Québec followed since 1997 with information on frequency of cannabis use (none/monthly/weekly), depression (defined as being in the top 10% symptoms) and serious suicidal ideation at ages 15, 17 and 20 years. Results:The prevalence of weekly cannabis use increased from 7.0% at age 15 years to 15.6% by age 20 years. Adolescents who reported using cannabis weekly at one age were 11 to 15 times more likely to continue using cannabis over time. In longitudinal cross-lagged analyses, weekly cannabis use at age 15 was associated with greater odds (OR:2.19, 95% CI:1.04-4.58) of suicidal ideation two years later. However, other substance use (alcohol, tobacco, other drugs) fully explained this association. Further, depression predicted subsequent weekly cannabis use, even after adjusting for comorbid other substance use (eg, for depression at 15 years predicting cannabis use at 17 years: OR:2.30, 95% CI:1.19-4.43).Limitations: Quantity of cannabis consumed was not measured. Conclusion:Findings suggest that depressive symptoms in adolescence may represent a risk factor for weekly cannabis consumption, which once initiated is likely to remain chronic.Weekly cannabis use increased risk for suicidal ideation, but not independently from other substance use including alcohol, tobacco and other drugs.

IMPORTANCE Household food insecurity has been associated with mental health problems in children independently of family income and other confounders. It is unclear whether food insecurity during childhood is also associated with mental health and functioning during adolescence. OBJECTIVE To evaluate longitudinal trajectories of household food insecurity during the first 13 years of life, characteristics associated with these trajectories, and the associations of the trajectories with externalizing, internalizing, substance use, and social adjustment problems at 15 years of age.

BackgroundWhile walking in nature has been shown to improve affect in adults from the community to a greater extent than walking in urban settings, it is unknown whether such findings can be generalized to individuals suffering from depression. Using a parallel group design, this randomized controlled trial examined the effects of a single walk in nature versus urban settings on negative and positive affect in adult psychiatric outpatients diagnosed with major depressive disorder (MDD).MethodParticipants recruited from a psychiatric outpatient clinic for adults with MDD were randomly assigned to a nature or urban walk condition. Thirty-seven adults (mean age=49 years) completed a single 60-minute walk. Negative and positive affect were assessed using The Positive and Negative Affect Schedule or PANAS at 6 time points: before the walk, halfway during the walk, immediately post-walk, at home before bedtime, 24 hours post-walk, and 48 hours post-walk.ResultsControlling for baseline levels of affect before the walk, individuals who walked in nature experienced overall lower levels of negative affect, F(1, 35.039)=4.239, p=.047, compared to those who walked in urban settings. Positive affect did not differ across walk conditions.LimitationsThe generalizability of results are limited by the small sample size and the presence of more female than male participants.ConclusionsWalking in nature might be a useful strategy to improve the affect of adults with MDD. Future research should investigate different ways to integrate the beneficial effects of nature exposure into existing treatment plans for psychiatric outpatients with MDD.

No abstract