Are factors associated with suicidal ideation true risk factors?

Background Adverse life events or the commencement of adverse lifestyles associate with suicidal ideation, but most associations only have been identified in cross-sectional studies. More information is needed about whether they are true risk factors and independently predict the development of suicidal ideation. Method A sample of the general population from Eastern Finland (n = 1,339) was followed-up for three-years with baseline and two follow-up assessments using postal questionnaires. The main adverse life events and changes in lifestyles were screened at baseline and on one- and three-year follow-up. The Beck Depression Inventory was used to assess the level of depression and the presence of suicidal ideation. Results Suicidal ideation was common in the sample (annual incidence 4.3%). At baseline it associated with a cluster of adverse life events and lifestyles, as well as depression. Nevertheless, only the Beck Depression Inventory score on 3-year follow-up (OR 1.33, 95% CI 1.22–1.45) and the onset of daily smoking during the follow-up period (OR 5.38, 95% CI 1.41–20.62) independently predicted the presence of suicidal ideation on 3-year follow-up among those who had been nonsuicidal at baseline and on 1-year follow-up. Conclusion Depressive mood appears to be a necessary precondition for the occurrence of suicidal ideation even after adverse life events