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Increased burden of cardiovascular risk among youth suicide attempters

Published online by Cambridge University Press:  19 October 2020

Yongqi Zhong
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA Department of Epidemiology, University of Pittsburgh, PA, USA
Steven Pham
Affiliation:
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
Giovanna Porta
Affiliation:
University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Antoine Douaihy
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
Anna Marsland
Affiliation:
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
David Brent
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
Nadine M. Melhem*
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
*
Author for correspondence: Nadine M. Melhem, E-mail: melhemnm@upmc.edu

Abstract

Background

Suicide and cardiovascular disease rank among the leading causes of disability and premature mortality worldwide. Young adult suicide attempters are at increased risk of mortality from cardiovascular disease even compared to those with major depressive disorder suggesting an increased burden of cardiovascular risk factors. We compared the cardiovascular risk burden between youth attempters and other high-risk individuals.

Methods

Participants were from the Collaborative Psychiatric Epidemiology Surveys (CPES), a U.S. population-based study, aged 18–30 years [suicide attempt (SA): n = 303; suicidal ideation (SI): n = 451; controls: n = 3671]; and psychiatric inpatients admitted for a SA (n = 38) or SI (n = 40) and healthy controls (n = 37) aged 15–30 years. We computed a cardiovascular risk score and high- and low-risk latent classes based on risk factors of high blood pressure, obesity, and smoking.

Results

Suicide attempters showed an increased cardiovascular risk score (CPES: B = 0.43, 95% confidence interval (CI) 0.31–0.54, p < 0.001; inpatient sample: B = 1.61, 95% CI 0.53–2.68, p = 0.004) compared to controls. They were also more likely to be classified in the high cardiovascular risk group (CPES: odds ratio (OR) 3.36, 95% CI 1.67–6.78, p = 0.001; inpatient sample: OR 9.89, 95% CI 1.38–85.39, p = 0.03) compared to those with SI (CPES: OR 1.15, 95% CI 0.55–2.39, p = 0.71; inpatient sample: OR 1.91, 95% CI 0.25–15.00, p = 0.53).

Conclusions

Youth attempters show an increased burden for cardiovascular risk compared to other high-risk individuals in inpatient and population-based samples. Clinicians should pay particular attention to cardiovascular risk factors among suicide attempters in order to reduce their risk for cardiovascular events.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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