Evidence map›Paper›PMID 32398331›Full record

ArticleBMJ open2020

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.

Ela Polek, Sharon A S Neufeld, Paul Wilkinson, Ian Goodyer, Michelle St Clair, Gita Prabhu, Ray Dolan, Edward T Bullmore, Peter Fonagy, Jan Stochl and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.1field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 17 citations in OpenAlex.

  1. The social determinants of mental health and disorder: evidence, prevention and recommendations.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024
    Article
  2. Article
  3. Article
  4. Establishing a Theory-Based Multi-Level Approach for Primary Prevention of Mental Disorders in Young People.International journal of environmental research and public health · 2020
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Ela PolekPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK.ORCID 0000-0003-1405-2269
Sharon A S NeufeldPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK.
Paul WilkinsonPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK.
Ian GoodyerPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK.
Michelle St ClairPsychology, University of Bath, Bath, UK.
Gita PrabhuWellcome Centre for Human Neuroimaging, University College London, London, UK.
Ray DolanWellcome Centre for Human Neuroimaging, University College London, London, UK.
Edward T BullmorePsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK.
Peter FonagyResearch Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Jan StochlPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK.
Peter B JonesPsychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK pbj21@cam.ac.uk.
University of Cambridge · GBWellcome Centre for Human Neuroimaging · GBUniversity College Dublin · IEUniversity College London · GBUniversity of Bath · GB

Funding

Medical Research Council MC_G0802534Wellcome TrustWellcome Trust 074296Wellcome Trust 095844/Z/11/Z
6 · The paper itself

Abstract

objectivesTo 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.

designTwo independent population-based cohorts.

settingPopulation based in two UK centres.

participantsVolunteers 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).

resultsWe 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.

conclusionsNSSI 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.

Indexed as

Psychological DistressSuicidal IdeationSuicide PreventionAdolescentCohort StudiesFemaleHealth SurveysHumansLogistic ModelsMalePatient DropoutsPrevalenceReproducibility of ResultsRiskSelf-Injurious BehaviorUnited Kingdomchild & adolescent psychiatryepidemiologypublic healthsuicide & self-harm

Identifiers

PMID32398331
PMCPMC7223145
OpenAlexW3025394243

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.