Suicide Ideation During Adolescence and Predictors for Its Trajectories: A 6-Year Follow-Up Study in Korea

Suicide ideation experienced by adolescents may persist over time but is also subject to change. With due consideration of the changing nature of suicide ideation in adolescents, we aimed to identify the trajectories of suicide ideation and the protective and risk factors associated with each trajectory.

This study used a 6-year follow-up cohort of adolescents (n = 2,205) who were aged 13 years, first-year middle school students at baseline, from the Korean Children and Youth Panel Study. We conducted growth mixture modeling to characterize trajectories of suicide ideation, which were measured at four time points over the middle and high school periods. Using multinomial logistic regression, we analyzed a wide range of factors in relation to suicide ideation trajectories with adjustment for demographic and behavioral characteristics.

Suicide ideation reached a peak in the third year of middle school (15.7% at age 15). Three different trajectories (low, transient, and persistent) were identified. Depressive symptoms, maltreatment, and low self-esteem were associated with greater risk of both transient and persistent suicide ideation trajectories, but with a higher magnitude of association for the persistent trajectory. When transient and persistent trajectories were compared, depressive symptoms (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.08-1.94), cell phone dependency (OR = 1.20, 95% CI = 0.96-1.50), and self-esteem (OR = 0.79, 95% CI = 0.61-1.02) were differentiated two trajectories.

Similar protective and risk factors were associated with both transient and persistent suicide ideation but with stronger associations for persistent trajectories. Self-esteem, maltreatment, and depression may act as a broad-spectrum intervention point to target both transient and persistent suicide ideation.