Epidemiology: Open Access
Open Access

Abstract

Suicidal behaviour is of public health importance, and is increasing in young populations. Academic performance in youth measured in Grade Point Average (GPA), predicts suicide attempt but the mechanisms are not known. It has been suggested that general cognitive ability might underlie the association. We followed 26,315 Swedish women and men in the populationrepresentative evaluation through follow-up cohorts, up to maximum 46 years of age, for a first suicide attempt in recorded in the national inpatient register. Associations between GPA at age 16, IQ measured in school at age 13 and suicide attempt were investigated in Cox regression and mediation analyses, with control for potential confounders including socioeconomic position. 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. To conclude, academic performance in compulsory school was a robust predictor of suicide attempt past young adulthood. Rather than IQ accounting for the association, the association between IQ and suicide attempt was mediated by academic performance, highlighting the role of academic performance in long-term suicidal risk. Future studies should further investigate the key mechanisms in this association, and if interventions to improve academic performance have a long-term preventive effect on suicidal behaviour.

Biography

Alma Sorberg Wallin has a background in Clinical Psychology and completed her PhD in Social Epidemiology at the Karolinska Institute in Stockholm, Sweden, in 2015. She is currently working as Postdoctoral Researcher in a project on origins of educational gradients in health. She is a Managing Editor of the European Journal of Public Health. Her main interests are in Psychiatric Epidemiology and Suicidology.