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Background: Suicidal behaviors are prevalent among college students; however, students remain reluctant to seek support. We developed a predictive algorithm to identify students at risk of suicidal behavior and used telehealth to reduce subsequent risk. Methods: Data come from s everal waves of a prospective cohort study (2016–2022) of college students (n = 5454). All first-year students were invited to participate as volunteers. (Response rates range: 16.00–19.93%). A stepped-care approach was implemented: (i) all students received a comprehensive list of services; (ii) those reporting past 12-month suicidal ideation were directed to a safety planning application; (iii) those identified as high risk of suicidal behavior by the algorithm or reporting 12-month suicide attempt were contacted via telephone within 24-h of survey completion. Intervention focused on support/safety-planning, and referral to services for this high-risk group. Results: 5454 students ranging in age from 17–36 (s.d. = 5.346) participated; 65% female. The algorithm identified 77% of students reporting subsequent suicidal behavior in the top 15% of predicted probabilities (Sensitivity = 26.26 [95% CI 17.93–36.07]; Specificity = 97.46 [95% CI 96.21–98.38], PPV = 53.06 [95% CI 40.16–65.56]; AUC range: 0.895 [95% CIs 0.872–0.917] to 0.966 [95% CIs 0.939–0.994]). High-risk students in the Intervention Cohort showed a 41.7% reduction in probability of suicidal behavior at 12-month follow-up compared to high-risk students in the Control Cohort. Conclusions: Predictive risk algorithms embedded into universal screening, coupled with telehealth intervention, offer significant potential as a suicide prevention approach for students. [ABSTRACT FROM AUTHOR]

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Background: Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12‐month prevalence of BPB among college first‐year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning. Methods: Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross‐sectionally assessed 12‐month BPB and mental health problems among college first‐year students (n = 4,889; response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage "AYP" [0–100%] and academic failure) were obtained from administrative records at the end of the academic year. Results: Twelve‐month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4–18.4). Multivariate models showed associations with non‐suicidal self‐injury, post‐traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (−4.1 to −11.2% range) and elevated odds of academic year failure (ORs = 1.4–4.2). Conclusions: BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first‐year students. Further study is needed to examine the causal dynamics underlying these associations. [ABSTRACT FROM AUTHOR]

Aim: To assess gender differences in the association between risk/protective factors and suicidal thoughts and behaviors (STB); and whether there is any gender-interaction with those factors and STB; among Spanish university students.Methods: Data from baseline online survey of UNIVERSAL project, a multicenter, observational study of first-year Spanish university students (18-24 years). We assessed STB; lifetime and 12-month negative life-events and family adversities; mental disorders; personal and community factors. Gender-specific regression models and gender-interactions were also analyzed.Results: We included 2,105 students, 55.4% women. Twelve-month prevalence of suicidal ideation (SI) was 10%, plans 5.7%, attempts 0.6%. Statistically significant gender-interactions were found for lifetime anxiety disorder, hopelessness, violence between parents, chronic health conditions and family support. Lifetime mood disorder was a common risk factor of SI for both genders (Females: OR= 5.5; 95%CI 3.3-9.3; Males: OR= 4.4; 95%CI 2.0-9.7). For females, exposure to violence between parents (OR= 3.5; 95%CI 1.7-7.2), anxiety disorder (OR= 2.7; 95%CI 1.6-4.6), and alcohol/substance disorder (OR= 2.1; 95%CI 1.1-4.3); and for males, physical childhood maltreatment (OR= 3.6; 95%CI 1.4-9.2), deceased parents (OR= 4.6; 95%CI 1.2-17.7), and hopelessness (OR= 7.7; 95%CI 2.8-21.2), increased SI risk. Family support (OR= 0.5; 95%CI 0.2-0.9) and peers/others support (OR= 0.4; 95%CI 0.2-0.8) were associated to a lower SI risk only among females.Conclusions: Only mood disorder was a common risk factor of SI for both genders, whereas important gender-differences were observed regarding the other factors assessed. The protective effect from family and peers/others support was observed only among females. Further research assessing underlying mechanisms and pathways of gender-differences is needed. [ABSTRACT FROM AUTHOR]

Objective: We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental).Methods: First-year university students completed an online survey including Self-Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia-Suicide Severity Rating Scale (C-SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared.Results: A total of 2,118 students completed the survey (mean age = 18.8 [SD = 1.4] years; 55.4% female). Twelve-month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12-month SI were as follows: parental psychopathology (OR = 1.7, 95% CI 1.2-2.5); sexual assault (OR = 5.6, 95% CI 1.4-22.1); lifetime mood disorder (OR = 5.2, 95% CI 3.5-7.7); and lifetime anxiety disorder (OR = 1.7, 95% CI: 1.1-2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR = 0.6, 95% CI 0.4-0.9 for the second highest tertile) and family (OR = 0.4, 95% CI 0.3-0.7 for the highest tertile). AUC of the final model was 0.82 (SE = 0.015).Conclusion: Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model. [ABSTRACT FROM AUTHOR]

Background: Approximately one in five college students report a history of nonsuicidal self-injury. However, it is unclear how many students meet criteria for the recently proposed DSM-5 nonsuicidal self-injury disorder (NSSI-D). In this study, we used full NSSI-D criteria to identify those students most in need of clinical care.Methods: Using data from the Leuven College Surveys (n = 4,565), we examined the 12-month prevalence of DSM-5 NSSI-D in a large and representative sample of incoming college students. We also explored the optimal frequency threshold as a function of interference in functioning due to NSSI, and examined comorbidity patterns with other 12-month mental disorders (i.e., major depressive disorder, broad mania, generalized anxiety disorder, panic disorder, and alcohol dependence) and suicidal thoughts and behaviors (STB).Results: Twelve-month NSSI-D prevalence was 0.8% and more common among females (1.1%) than males (0.4%). The proposed 5+ diagnostic threshold was confirmed as yielding highest discrimination between threshold and subthreshold cases in terms of distress or disability due to NSSI. A dose-response relationship was observed for NSSI recency-severity (i.e., 12-month NSSI-D, subthreshold 12-month NSSI-D, past NSSI, no history of NSSI) with number of 12-month mental disorders and STB. NSSI-D occurred without comorbid disorders for one in five individuals, and remained associated with severe role impairment when controlling for the number of comorbid disorders.Conclusions: These findings offer preliminary evidence that DSM-5 NSSI-D is uncommon among incoming college students, but may help to improve the deployment of targeted resource allocation to those most in need of services. More work examining the validity of NSSI-D is required. [ABSTRACT FROM AUTHOR]

Childhood/adolescence adversities and mental disorders are higher among LGB youths. To evaluate the role of childhood maltreatment, bullying, and mental disorders on the association between sexual orientation and suicidal ideation (SI); and the role of mental disorders on the association between sexual orientation discrimination and SI. Baseline and 12-month follow-up online surveys of Spanish first-year university students (18–24-year-olds). Multivariable logistic regression models assessed the effects of childhood/adolescence adversities and mental disorders in the relationship between sexual orientation, discrimination and SI. A total of 1224 students were included (16.4 % LGBs). Risk factors of lifetime SI were sexual orientation (OR 2.4), any bullying (OR 2.4), any childhood maltreatment (OR 4.0), and any mental disorders (OR 3.8). Final model Area Under the Curve (AUC) 0.78. Among homosexual and bisexual students, discrimination showed increased risk of 12-month SI (OR 2.2), but this effect was no longer statistically significant when any 12-month mental disorder was added (OR 7.8). Final model AUC 0.72. Sample of interest was relatively small. But it was similar to comparable studies and statistical adjustments have been performed. Assessment of mental disorders and SI was not based on clinical assessment. However, validated scales showing good diagnostic agreement with clinical judgement were used. Childhood/adolescence adversities and mental disorders interact in the association between sexual orientation and SI. Mental disorders may mediate the association between sexual orientation discrimination and SI. Further research using larger samples and causal modelling approach assessing the mediators of SI risk among LGBs is needed. • Suicidal thoughts and behaviours are higher among LGB Spanish university students. • Childhood maltreatment and bullying increase the odds of suicidal ideation among LGBs. • Sexual orientation discrimination increased the odds of suicidal ideation. • Odds of suicidal ideation could be mediated by mental disorders among LGBs. [ABSTRACT FROM AUTHOR]

Background: Longitudinal evidence about risk and protective factors for suicidal ideation among university students is limited.Methods: 12-month first-onset and persistence of suicidal ideation (SI) among Spanish first-year university students were estimated using baseline (T1) and 12-month follow-up (T2) online surveys. Information about STBs, childhood/adolescence adversities, positive relationships, mental disorders, recent stressful experiences, and university sense of membership was assessed. Logistic regression analysis was used to study risk/protective factors of first-onset and persistence of suicidal ideation (SI).Results: A total of 1,248 respondents (58.9% response) were included. Mean age at baseline was 18.7 (SD = 1.3) and 56.0% were female. 7.3% reported 12-month SI at T2. Incidence of new SI cases was 3.4% and, among students with SI at T1, 21.2% also reported SI at T2 (persistence). Risk factors of T2 SI included 12-month mood disorder at T2 both without (aOR = 12.08 95% CI 5.45-26.80) or with (aOR = 7.2 95% CI 2.91-17.80) lifetime mood at T1, past lifetime suicide attempt (aOR = 8.79 95% CI 2.37-32.64) and plan without attempt (aOR = 4.72 95% CI 2.32-9.61), and 12-month physical or sexual assault (aOR = 3.28 95% CI 1.13-9.46). Twelve-month mood at T2 withoutT1 lifetime mood (aOR = 11.27 95% CI 3.02-42.14) and childhood/adolescence emotional abuse or neglect (aOR = 3.41 95% CI 1.10-10.57) or having been bullied (aOR = 3.2 95% CI 1.08-9.53) were associated with first-onset of SI. Twelve-month mood at T2 either without (aOR = 13.92 95% CI 3.76-51.59) or with (aOR = 8.03 95% CI 2.13-30.29) were associated to T2 SI persistence. University sense of membership was protective for overall 12-month SI at T2 (aOR = 0.25 95% CI 0.12-0.53 for middle tertile), first-onset SI (aOR = 0.1 95% 0.02-0.55 for middle tertile) and persistence (aOR = 0.3 95% CI 0.11-0.81 for middle tertile).Limitations: Analysis was based on self-report data focusing on SI only, and conclusions about the direction of the associations are limited.Conclusions: High proportion of SI suggests the need of suicide prevention strategies. The potential role of university sense of membership in reducing suicidal behaviour among university students deserves further investigation. [ABSTRACT FROM AUTHOR]