Reporting of suicidal ideation/attempt during adolescence and young adulthood: A data linkage analysis of medical records and self-report questionnaires

Surveys on adolescent suicidal ideation and attempts predominantly utilize self-report questionnaires (Hallford et al., 2023; Plöderl et al., 2011). Increasingly, these surveys are being complemented with linked medical records (Anderson et al., 2015; Nock et al., 2022; Schriver et al., 2020) of suicidal ideation/attempt. Despite this, concordance and discordance between self-report data and medically obtained information remains largely unexplored, with virtually all studies focusing on the agreement between self-reports, parental reports, and clinician assessments (Jones et al., 2019; Klaus et al., 2009; Lungu et al., 2019; Terrill et al., 2021; Vera-Varela et al., 2022). The notable exception is the Avon Longitudinal Study of Parents and Children (ALSPAC), where Mars et al. (2016) uniquely combined self-reported questionnaires on self-harm with hospital records, encompassing admissions for self-harm, outpatient visits, and emergency visits. This study found that non-completion of the self-harm questionnaire was associated with higher hospital admissions for self-harm. Additionally, it highlighted that around 20% of medically documented self-harm incidents were not reported by participants in their self-assessments. However, this study was limited by its inability to examine individual and familial characteristics associated with discordance between self-report and medical records or to detect differences between questionnaire responders and non-responders, due to low rates of self-harm recorded in medical records. Additionally, the study's generalizability is limited by its reliance on linked hospital self-harm admissions data for only 24% of a subsample who consented to data linkage. This study also only examined self-harm and did not include indices of ideation. Similar to ALSPAC, the Quebec Longitudinal Study of Child Development (QLSCD; Orri et al., 2021) a population-based study tracking 2,120 individuals from birth (late 1990s) to adulthood, collected multiple waves of self-reported data on suicidal ideation and attempts. This study was enriched by linking medical records on suicidal ideation and attempts for over 98% of the participants, along with data on key individual and familial characteristics to more accurately identify factors associated with self-reported and medically identified suicidal ideation/attempt. Using data from the Quebec Longitudinal Study of Child Development, which includes self-reported past-year suicidal ideation/attempts at ages 17, 20, and 23, along with corresponding medical records for suicidal ideation/attempts, our objectives are to: 1. Explore concordance and discordance in reporting of suicidal ideation/attempts as identified through self-reports and medical records across ages 17, 20 and 23 years. 2. Examine the association of individual factors (e.g., emotional/behavioral problems) and familial factors (e.g., family functioning) during childhood (6 to 12 years) with reporting concordance and discordance of suicidal ideation/ attempts, as identified through self-reports and medical records.

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