Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 1;82(9):916-925.
doi: 10.1001/jamapsychiatry.2025.1273.

Mental Health Antecedents and Correlates of 2 Distinct Developmental Pathways to Suicidal Ideation

Marie-Claude Geoffroy  1 , Sasha MacNeil  2 , Vincent Paquin  3 , Ayla Inja  2 , Alain Girard  4 , Élise Chartrand  2 , Natalie Castellanos-Ryan  5 , Charles-Édouard Notredame  6 , Ian Colman  7 , Massimiliano Orri  1   8 , Gustavo Turecki  2 , Sylvana Côté  9   10
Affiliations

Mental Health Antecedents and Correlates of 2 Distinct Developmental Pathways to Suicidal Ideation

Marie-Claude Geoffroy et al. JAMA Psychiatry. .

Abstract

Importance: Suicidal ideation is increasingly common in youth. Trajectories and associated mental health symptoms across development remain poorly understood.

Objective: To describe trajectories of suicidal ideation from early adolescence to young adulthood and identify preceding and co-occurring mental health symptoms to inform optimal prevention.

Design, setting, and participants: This cohort study used data from a contemporary, longitudinal cohort study, the Québec Longitudinal Study of Child Development (QLSCD), including reports from participants, parents, and teachers. The QLSCD is a population-based birth cohort study of 2120 singletons born between 1997 and 1998 in Québec, Canada, and followed up to age 25 years (2023). Data were analyzed from September 2024 to February 2025.

Main outcomes and measures: Serious suicidal ideation in the past 12 months was assessed by a question to participants at ages 13, 15, 17, 20, 23, and 25 years.

Exposures: Mental health symptoms (eg, internalizing, externalizing) as reported by parents, teachers, and self-reports on validated questionnaires and standardized across 5 developmental periods: preschool (3-5 years), childhood (6-12 years), early adolescence (13 years), mid-late adolescence (15-17 years), and young adulthood (20-25 years).

Results: A total of 1635 participants (845 female [51.7%]; participant number is weighted to account for selective attrition) provided answers on suicidal ideation, with survey weights applied. A total of 3 trajectories were identified: minimal/no ideation (1433 [87.6%]), onset in early adolescence (117 [7.1%]), and onset in young adulthood (86 [5.2%]). Relative to minimal/no ideation, onset in early adolescence was associated with elevated symptoms across nearly all mental health indicators from childhood through adulthood. This included both internalizing (eg, childhood depressive symptoms: risk ratio [RR], 1.75; 95% CI, 1.45-2.05) and externalizing (eg, childhood disruptive symptoms: RR, 1.60; 95% CI, 1.29-1.91) symptoms and maternal antisocial symptoms (RR, 1.39; 95% CI, 1.11-1.66). In contrast, onset of suicidal ideation in young adulthood was associated with internalizing symptoms (eg, mid-late adolescence depressive symptoms: RR, 1.84; 95% CI, 1.28-2.39) emerging in adolescence and worsening mental distress in young adulthood.

Conclusions and relevance: Results of this cohort study revealed 2 pathways to suicidal ideation: onset in early adolescence, with persistent childhood internalizing/externalizing symptoms, and onset in young adulthood linked to internalizing symptoms emerging in adolescence without prior distress. Findings suggest timely addressing of mental health symptoms and developmental stage-specific prevention.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Profs Geoffroy, Orri, Côté, and Turecki reported holding a Canada Research Chair position. Dr Côté reported receiving grants from the Canadian Institute for Health Research during the conduct of the study. No other disclosures were reported.

References

    1. Center for Disease Control and Prevention . YRBS data summary & trends report. Accessed October 7, 2024. https://www.cdc.gov/yrbs/dstr/index.html
    1. Simes D, Shochet I, Murray K, Sands IG. A systematic review of qualitative research of the experiences of young people and their caregivers affected by suicidality and self-harm: implications for family-based treatment. Adolesc Res Rev. 2022;7(2):211-233. doi: 10.1007/s40894-021-00164-3 - DOI
    1. Madigan S, Korczak DJ, Vaillancourt T, et al. Comparison of pediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation before and during the COVID-19 pandemic: a systematic review and meta-analysis. Lancet Psychiatry. 2023;10(5):342-351. doi: 10.1016/S2215-0366(23)00036-6 - DOI - PMC - PubMed
    1. Cantor N, Kingsbury M, Warner E, et al. Young adult outcomes associated with adolescent suicidality: a meta-analysis. Pediatrics. 2023;151(3):e2022058113. doi: 10.1542/peds.2022-058113 - DOI - PubMed
    1. Nock MK, Green JG, Hwang I, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry. 2013;70(3):300-310. doi: 10.1001/2013.jamapsychiatry.55 - DOI - PMC - PubMed