Diagnostic delays and suicidal thoughts and behaviors among young adults with a history of mood disorders.

Introduction: Suicidal thoughts and behaviors (STBs) are prevalent among young adults with mood disorders. This study examined whether length of diagnostic delay was independently associated with risk for STBs. Materials and methods: Data were from a national online survey of US adults ages 18-35 years with a lifetime mood disorder diagnosis (N = 464). Modified Poisson regression estimated adjusted risk ratios (aRRs) for associations between diagnostic delay (<1, 1-2, 3-4, 5+ years) and three lifetime and past 6-month STB outcomes: suicidal ideation (SI), suicide attempt (SA), and non-suicidal self-injury (NSSI). Results: Median diagnostic delay was 3 years (IQR = 0-7 years). Delays of 1-2 years (aRR=1.23, 95% CI = 1.03-1.47, p=0.021) and 3-4 years (aRR=1.26, 95% CI = 1.07-1.49, p=0.006) were associated with higher lifetime SI risk. A 3-4-year delay was associated with past 6-month SI (aRR=1.37, 95% CI = 1.02-1.85, p=0.038). Diagnostic delay was not significantly associated with SA or NSSI. Sexual minority status and adverse childhood experiences were associated with elevated risk for multiple STB outcomes, and social support was protective. Discussion: Diagnostic delay may be associated with elevated risk for SI in young adults with mood disorders; longitudinal studies are needed to further investigate the temporal relationship between diagnostic delays and risk for STBs within this population.