Poor academic performance a predictor of suicide risk

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PoorSchoolPerformanceA Swedish study has shown that poor academic performance, measured as grade point average (GPA) at age 16, was a robust and strong predictor of suicide attempt up to middle age.

For the study, researchers followed 26,315 Swedish girls and boys up to maximum 46 years of age. After controlling for potential confounding factors including childhood IQ, those in the lowest GPA quartile had a near five-fold higher risk of suicide attempt than those in the highest quartile.

“This is a highly elevated risk, and it is remarkable that it reaches far into adulthood. We would however need to know more to identify helpful interventions – for example, is school failure in itself a risk factor, or is poor performance rather an indicator of vulnerability?” said lead author Dr Alma Sorberg Wallin, of the Karolinska Institutet, in Stockholm, Sweden.

Abstract
Objective: Academic performance in youth, measured by grade point average (GPA), predicts suicide attempt, but the mechanisms are not known. It has been suggested that general intelligence might underlie the association.
Methods: We followed 26 315 Swedish girls and boys in population-representative cohorts, up to maximum 46 years of age, for the first suicide attempt in hospital records. Associations between GPA at age 16, IQ measured in school at age 13 and suicide attempt were investigated in Cox regressions and mediation analyses.
Results: There was a clear graded association between lower GPA and subsequent suicide attempt. With control for potential confounders, those in the lowest GPA quartile had a near five-fold risk (HR 4.9, 95% CI 3.7–6.7) compared to those in the highest quartile. In a mediation analysis, the association between GPA and suicide attempt was robust, while the association between IQ and suicide attempt was fully mediated by GPA.
Conclusions: Poor academic performance in compulsory school, at age 16, was a robust predictor of suicide attempt past young adulthood and seemed to account for the association between lower childhood IQ and suicide attempt.

Authors
A Sörberg Wallin, Z Zeebari, A Lager, D Gunnell, P Allebeck, D Falkstedt

Wiley material
Acta Psychiatrica Scandinavica abstract


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