ArticlePsychiatry research2025
The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student Initiative.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Psychological factors mediating/moderating the association between adverse childhood experiences and suicidal ideation in young people: a systematic review.European child & adolescent psychiatry · 2026Pooled it
- Does child abuse influence the persistence of suicidal ideation in patients with high suicide risk?European journal of psychotraumatology · 2026Article
- Prevalence and associations of lifetime, 12-month, and 30-day suicidal thoughts and behaviours among 3,702 First-Year university students in New Zealand.Social psychiatry and psychiatric epidemiology · 2026Article
- Suicidal ideation and its determinants among Palestinian university students.Scientific reports · 2026Article
- Mental disorders & self-injurious thoughts and behaviors predict high risk of role impairment among university students - results from the world mental health international college student initiative.Journal of affective disorders · 2026Article
- Beyond mental disorders: The role of child maltreatment in childhood suicidal behaviour.The Australian and New Zealand journal of psychiatry · 2026Article
- Reducing Disparities and Improving Mental Health for Transgender Persons.Alpha psychiatry · 2026Article
- Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative.Psychiatry research · 2025Article
- Stressful Life Events and Chronic Stressors as Predictors of Psychopathological Conditions in the WMH-ICS Initiative.Salud mental (Mexico City, Mexico)Article
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Authors and funding
71 authors.
Philippe MortierHealth Services Research Group, Hospital del Mar Research Institute, Carrer del Doctor Aiguader, 88 08003 Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain.
Xue YangThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
Yasmin A AltwaijriBiostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Jacob A HoldcraftDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Sue LeeDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Nancy A SampsonDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Yesica AlborCenter for Global Mental Health Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.
Ahmad N AlhadiDepartment of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia; SABIC Psychological Health Research & Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Jordi AlonsoHealth Services Research Group, Hospital del Mar Research Institute, Carrer del Doctor Aiguader, 88 08003 Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain; Department of Medicine and Life Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. Electronic address: jalonso@researchmar.net.
Nouf K Al-SaudBiostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Claes AnderssonDepartment of Criminology, Malmö University, Malmö, Sweden.
Lukoye AtwoliDepartment of Medicine, Medical College East Africa, the Aga Khan University, Nairobi, Kenya; Brain and Mind Institute, the Aga Khan University, Nairobi, Kenya; Department of Mental Health and Behavioural Sciences, Moi University School of Medicine, Eldoret, Kenya.
Randy P AuerbachDepartment of Psychiatry, Columbia University, New York, NY, USA.
Caroline Ayuya MuakaDepartment of Psychology & Counselling, Daystar University, Nairobi, Kenya.
Patricia M Báez-MansurCoordinación de Desarrollo Académico y Servicios Educativos, Universidad la Salle Ciudad Victoria, Ciudad Victoria, Mexico.
Laura BallesterHealth Services Research Group, Hospital del Mar Research Institute, Carrer del Doctor Aiguader, 88 08003 Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain.
Jason BantjesMental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Institute for Life Course Health Research, Global Health, Stellenbosch University.
Harald BaumeisterDepartment of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany.
Marcus BendtsenDepartment of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden.
Corina BenjetCenter for Global Mental Health Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.
Anne H BermanDepartment of Psychology, Uppsala University, Uppsala, Sweden.
Ronny BruffaertsCenter for Public Health Psychiatry, Department of Neurosciences, Katholieke Universiteit Leuven (KUL), Leuven, Belgium; Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium; WHO Collaborating Centre for Public Health Psychiatry, KU Leuven, Belgium.
Paula CarrascoCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain; Department of Medicine, Universitat Jaume I, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain.
Silver C N ChanThe Hong Kong University of Science and Technology, Hong Kong SAR, PR China.
Irina CohutCareer Counseling and Guidance Center, Technical University of Cluj-Napoca, Romania.
María Anabell Covarrubias Díaz CouderCoordinación de Investigación, Universidad La Salle Noroeste.
Marcelo A CrockettNucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile.
Pim CuijpersFaculty of Behavioural and Movement Science, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands; Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.
Oana A DavidDATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.
Dong DongThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
David D EbertSchool of Medicine and Health, Department for Sport and Health Sciences, Technical University Munich, Germany.
Jorge GaeteNucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile; Centro de Investigación en Salud Mental Estudiantil (ISME), Facultad de Ciencias Sociales, Universidad de los Andes, Santiago, Chile.
Mireia Felez-NobregaParc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat , Barcelona, Spain.
Carlos García ForeroDepartamento de Medicina, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
Margalida GiliDepartment of Psychology, University of the Balearic Islands (UIB), Palma, Mallorca, Spain.
Raúl A Gutiérrez-GarcíaUniversidad La Salle Bajío, campus Salamanca, Mexico.
Josep Maria HaroParc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat , Barcelona, Spain; Centro de investigación Biomédica en Red en Salud Mental (CIBERSAM), ISCIII, Madrid, Spain.
Penelope HaskingSchool of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Curtin enAble Institute, Curtin University, Perth, Australia.
Xanthe HuntMental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa; Africa Health Research Institute (AHRI), Durban, South Africa.
Mathilde M HuskyActive Team, Bordeaux Population Health Research Center, INSERM U1219, University of Bordeaux, France.
Florence JagugaDepartment of Alcohol and Drug Abuse Rehabilitation Services, Moi Teaching and Referral Hospital, Eldoret, Kenya.
Leontien JansenCenter for Public Health Psychiatry, Department of Neurosciences, Katholieke Universiteit Leuven (KUL), Leuven, Belgium; Universitair Psychiatrisch Centrum KU Leuven (UPC-KUL), Leuven, Belgium.
Álvaro I LangerNucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile; Facultad de Psicología y Humanidades, Universidad San Sebastián, Santiago, Chile.
Yan LiuSchool of Public Health, Jining Medical University, Jining 272067, Shandong Province, PR China.
Scarlett Mac-GintyNucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile; Department of Health Service & Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Vania MartínezNucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile; Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (Cemera), Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Andre MasonSchool of Psychological and Social Sciences, University of Waikato, Hamilton, New Zealand.
Muthoni MathaiDepartment of Psychiatry, Faculty of Health Sciences, University of Nairobi, Kenya.
Margaret McLaffertyPersonalised Medicine Centre, School of Medicine, Ulster University, Derry/Londonderry, UK; Atlantic Technological University, Donegal, Ireland.
Andrea Miranda-MendizabalCentro de investigación Biomédica en Red en Salud Mental (CIBERSAM), ISCIII, Madrid, Spain; Sant Joan de Déu Research Institute, Carrer de Santa Rosa, 39-57, 08950, Esplugues del Llobregat, Spain.
Elaine K MurrayPersonalised Medicine Centre, School of Medicine, Ulster University, Derry/Londonderry, UK.
Catherine M MusyokaDepartment of Psychiatry, Faculty of Health Sciences, University of Nairobi, Kenya.
Siobhan M O'NeillSchool of Psychology, Ulster University, Coleraine, UK.
Claudiu C PapasteriDepartment of Psychology and Cognitive Sciences, University of Bucharest, Romania.
José A PiquerasDepartment of Health Psychology, Universidad Miguel Hernandez de Elche (UMH), Alicante, Spain.
Codruta A PopescuDepartment of Human Sciences, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Charlene RapseyDepartment of Psychological Medicine, University of Otago, Dunedin, New Zealand.
Kealagh RobinsonSchool of Psychology, Massey University, Wellington, New Zealand.
Tiscar Rodriguez-JimenezDepartment of Psychology and Sociology, Universidad de Zaragoza (UNIZAR), Zaragoza, Spain.
Damian ScarfDepartment of Psychology, University of Otago, Dunedin, New Zealand.
Oi-Ling SiuDepartment of Psychology, Lingnan University, Hong Kong, SAR, China.
Dan J SteinSAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa.
Sascha Y StruijsFaculty of Behavioural and Movement Science, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands.
Cristina T TomoiagaDATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania.
Karla Patricia Valdés-GarcíaFacultad de Psicología, Universidad Autónoma de Coahuila, Saltillo, Mexico.
Shelby VereeckeDepartment of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Daniel V VigoDepartment of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Angel Y WangDepartment of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Samuel Y S WongThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
World Mental Health International College Student collaborators
Funding
Risk Factors for Psychopathology in the WHO WMH SurveysR01MH070884 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 2005 to 2009
$6.0MSocial Role Disability and Mental-Physical Co-MorbidityR01MH069864 · NIMH · KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · PI VON KORFF, MICHAEL R · 2004 to 2007
$2.2MCROSS-NATIONAL STUDIES OF DRUG INVOLVEMENT: WMH2000R01DA016558 · NIDA · MICHIGAN STATE UNIVERSITY · PI ANTHONY, JAMES CHRISTOPHER · 2003 to 2008
$1.7MWorld Mental Health Consortium Annual Meeting 2003-07R13MH066849 · NIMH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HEERINGA, STEVEN G · 2003 to 2007
$735kPredicting Internet-Based Treatment Response for Major Depressive DisorderR56MH109566 · NIMH · MCLEAN HOSPITAL · PI AUERBACH, RANDY PATRICK · 2016 to 2017
$685kLebanon-Epidemiology: The NCS Replication StudyR03TW006481 · FIC · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 2004 to 2006
$142kFIC NIH HHS R03 TW006481NIDA NIH HHS R01 DA016558NIMH NIH HHS R01 MH069864NIMH NIH HHS R01 MH070884NIMH NIH HHS R13 MH066849NIMH NIH HHS R56 MH109566Wellcome Trust
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.
Indexed as
Adverse Childhood ExperiencesMental DisordersStudentsSuicidal IdeationSuicide, AttemptedAdolescentAdultFemaleGlobal HealthHumansMalePrevalenceUniversitiesYoung AdultAdverse childhood experiencesMental healthPrevalenceRisk factorsSelf-injurious behaviorStudentsSuicide
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