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dc.contributor.authorPolek, Elaen
dc.contributor.authorNeufeld, Sharonen
dc.contributor.authorWilkinson, Paulen
dc.contributor.authorGoodyer, Ianen
dc.contributor.authorSt Clair, Michelleen
dc.contributor.authorPrabhu, Gitaen
dc.contributor.authorDolan, Rayen
dc.contributor.authorBullmore, Edwarden
dc.contributor.authorFonagy, Peteren
dc.contributor.authorStochl, Janen
dc.contributor.authorJones, Peteren
dc.date.accessioned2020-04-03T23:30:46Z
dc.date.available2020-04-03T23:30:46Z
dc.date.issued2020-05-11en
dc.identifier.issn2044-6055
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/304081
dc.description.abstractObjectives: 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 age 14-24 years recruited from primary health care registers, schools and colleges, with advertisements to complete quotas in age-sex-strata. Cohort 1 is the Neuroscience in Psychiatry Network (NSPN; 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 suicidal thoughts (ST) and non-suicidal self-injury (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 two standard deviations 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 common mental distress 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.
dc.description.sponsorshipThe ROOTS study was supported by a Wellcome Trust Grant (Grant number 074296) to I.M.G. and P.B.J., the NIHR Collaborations for Leadership in Applied Research and Care (CLAHRC) East of England, and the NIHR Cambridge Biomedical Research Centre. The NSPN study was supported by the Wellcome Trust Strategic Award (095844/Z/11/Z) to I.M.G., E.B., P.B.J., R.D., P.F. The work has been carried out in the Department of Psychiatry, University of Cambridge. We wish to thank the NSPN and ROOTS participants and Dr Golam Khandaker for his comments and NSPN Consortium (see the list of members in the Supplement).
dc.format.mediumElectronicen
dc.languageengen
dc.publisherBMJ Journals
dc.rightsAll rights reserved
dc.rights.uri
dc.subjectHumansen
dc.subjectHealth Surveysen
dc.subjectPrevalenceen
dc.subjectLogistic Modelsen
dc.subjectRisken
dc.subjectCohort Studiesen
dc.subjectReproducibility of Resultsen
dc.subjectSelf-Injurious Behavioren
dc.subjectSuicideen
dc.subjectAdolescenten
dc.subjectPatient Dropoutsen
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectYoung Adulten
dc.subjectSuicidal Ideationen
dc.subjectUnited Kingdomen
dc.subjectPsychological Distressen
dc.titleHow 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.en
dc.typeArticle
prism.issueIdentifier5en
prism.publicationDate2020en
prism.publicationNameBMJ openen
prism.startingPagee032494
prism.volume10en
dc.identifier.doi10.17863/CAM.51163
dcterms.dateAccepted2020-03-31en
rioxxterms.versionofrecord10.1136/bmjopen-2019-032494en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2020-05-11en
dc.contributor.orcidPolek, Ela [0000-0003-1405-2269]
dc.contributor.orcidNeufeld, Sharon [0000-0001-5470-3770]
dc.contributor.orcidWilkinson, Paul [0000-0003-3302-9662]
dc.contributor.orcidGoodyer, Ian [0000-0001-9183-0373]
dc.contributor.orcidSt Clair, Michelle [0000-0003-4015-7435]
dc.contributor.orcidBullmore, Edward [0000-0002-8955-8283]
dc.contributor.orcidFonagy, Peter [0000-0003-0229-0091]
dc.contributor.orcidStochl, Jan [0000-0002-9693-9930]
dc.contributor.orcidJones, Peter [0000-0002-0387-880X]
dc.identifier.eissn2044-6055
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idWellcome Trust (095844/Z/11/Z)
pubs.funder-project-idWellcome Trust (074296/Z/04/Z)
pubs.funder-project-idMRC (MC_G0802534)
cam.orpheus.counter6*
rioxxterms.freetoread.startdate2023-04-03


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