Associação entre eventos adversos na infância e adolescência e comportamentos suicidas em pertencentes à Coorte de Nascimentos de Pelotas de 1993

Abstract

Introduction: Adverse events, also called stressful events or stressors, are events that can cause stress and tension, interfering with the behavior of individuals. The recent literature demonstrates that during childhood and adolescence some adverse events (such as domestic violence, family dysfunction, mental disorders among household members, physical or emotional neglect, parental death, parental divorce, physical abuse, and sexual abuse or harassment) are associated with suicidal behaviors (persistent ideation, planning and suicide attempt) and, also, a dose response relationship between the number of adverse events experienced and suicidal behaviors. Most of the studies on these associations are cross-sectional, with few longitudinal ones with young adults followed since birth or childhood. Objective: To assess if adverse childhood experiences are prospectively associated with lifetime suicide attempt and suicidal thoughts at young adulthood. Methods: Data from participants in the 1993 Pelotas Birth Cohort were used. Suicidal behavior was measured at age 22 using the MINI (Mini International Neuropsychiatric Interview), assessing past-month suicidal thoughts and lifetime suicide attempt. The exposures were collected at the 11-year follow- up. Physical abuse, discrimination, parental divorce/separation, parental death, and financial hardship were assessed using standardized questionnaires, maternal common mental disorders were measured using the SRQ-20. Analyzes were performed using crude and adjusted, for sex, skin color, parental education (perinatal) and family income (perinatal), logistic regressions. Results: As main results, the following stand out: In the adjusted model, those who suffered financial hardship (OR 2.51; 95% CI 1.66-3.79), experienced parental divorce (OR 1.44; 95% CI 1.02-2.04) and maternal CMD (OR 1.72; 95% CI 1.21-2.46) at 11 years were more likely to report suicidal thoughts at 22 years. Also, those who experienced financial hardship (OR 1.71; 95% CI 1.13-2.58), physical abuse (OR 1.48; 95% CI 1.08-2.04), discrimination (OR 1.74; 95% CI 1.20-2.51), maternal CMD (OR 1.67; 95% CI 1.20-2.32), or parental divorce (OR 1.41; 95% CI 1.02-1.94) were more likely to report a lifetime suicide attempt. Conclusion: There was a strong association between financial hardship, maternal CMD and divorce during childhood, and suicidal thoughts, such as suicidal ideation or planning, at the beginning of adulthood. Financial hardship, discrimination, divorce, maternal CMD and physical abuse were associated with suicide attempt. These findings demonstrate that mental health support must be available following certain ACEs during childhood, alongside with ACEs prevention. More research is needed on the association between discrimination and suicide attempts, differentiating the nature of each type of discrimination.