Mental Disorders and Subsequent Suicide in A Representative Community Population
Bibliographic record
Abstract
BackgroundExisting association between mental disorders and suicidality is mostly based on cross- sectional studies, using clinical samples. Objective and methodsWe examined the patterns of association between mental disorders and subsequent suicide in a representative sample of the Canadian household population. This is a retrospective cohort study that used data from the Canadian Community Health Survey 2002 linked to the Death Database 2000-2011 and the Hospitalization Database 1999/2000-2012/2013) (N=27,000). Mental disorders (past-year major depressive episodes (MDE), bipolar disorders (BPD), anxiety disorders (AD), and substance-dependent (SD)) were diagnosed in the survey data using the Composite International Diagnostic Interview. Subsequent suicide events (deaths/hospitalizations for suicide attempts) were identified using ICD-10-CA codes. Time-to-event data were analyzed using competing-risk regression models, adjusting for age, sex, marital status, and educational attainment. Due to the violation of the proportional hazard assumption, the models were stratified into two strata. Sampling weights were used to ensure representation of the target population. ResultsOf 27,000 respondents, mental disorders were diagnosed in 15.0% respondents and 0.4% had suicide events. Each mental disorder was significantly associated with an increased risk of suicide. The strength of association between mental disorder and suicide weakened over-time for MDE, SD, but not for BPD and AD. For example, using the time-to-event cut-off 4-year, the hazard ratio (HR) for MDE was 6.02 (95% CI=2.65,13.68) in the first 4-year, whereas, it was 2.03 (95% CI=0.91,4.53) after 4-year. The HRs of suicide for BPD were 16.95 (95% CI=6.88,41.75) and 15.81 (95% CI=5.89,42.45) before and after 4-year. Conclusions/ImplicationsFindings reflect improvement of suicide-risk over-time for people with MDE and SA and the persisting risk for people with BPD and AD. Our findings underscore the importance of early management of mental disorders for effective suicide prevention, and requirement of longer-term follow-up for people with BPD and AD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".