Adolescent suicidal distress and adult mental health: findings from a 25-year population based cohort.

Suicidal distress is common during adolescence, yet its descriptive associations with adult mental health are not well characterized. Using 25 years of prospective data, we examined how adolescent suicidal ideation (and characteristics-recurrence, seriousness, onset) and suicide attempt are associated with self-reported and clinically diagnosed adulthood mental health. Participants were drawn from the Quebec Longitudinal Study of Child Development, a population-based cohort followed from birth (1997/98) to age 25 (n = 2,120). Adolescent suicidal ideation and attempt were self-reported at ages 13-17. Self-reported young-adult outcomes included depressive symptoms, anxiety symptoms, binge drinking, cannabis use, life satisfaction, non-suicidal self-injury, serious ideation, and attempt between ages 19-25. In addition, administrative records identified clinically diagnosed depression and anxiety, substance-related, and suicide-related disorders between ages 18-25. Associations were examined using generalized linear and logistic models adjusted for sex, race and ethnicity, and socioeconomic status. From ages 13-17, 35.6% (547/1538) of adolescents reported ideation and 5.6% (86/1538) reported an attempt. Adolescent suicidal distress was associated with poorer adult outcomes-including self-reported symptoms (standardized mean differences 0.22-0.65), clinically diagnosed depression/anxiety and substance-related disorders (ORs 1.82-2.97), and suicide-related behaviors (ORs 3.54-6.41). Among adolescents with ideation, recurrence was associated with higher depressive and anxiety symptoms and lower life satisfaction, while serious ideation was associated with persistent suicide-related behaviors. In this descriptive study, adolescent suicidal distress was associated with poorer adult mental health from symptoms to diagnoses. Findings underscore adolescence as a key period for supporting youth experiencing suicidal distress.