The Association Between Loneliness and Suicidal Behaviour Among Adolescents Who Experience a Relative or Friend's Suicide or Suicide Attempt: Longitudinal Study of the Add Health Cohort.

OBJECTIVE

Adolescents who experience a peer or relative's suicidal behavior can feel alienated from their peers and are at increased risk of suicidal thoughts and attempts. However, it is unclear whether loneliness is a risk factor for suicidal behavior in this vulnerable group.

METHOD: We analyzed data from 5,259 participants in the US National Longitudinal Study of Adolescent to Adult Health (Add Health) reporting past-year experience of the suicide or suicide attempt of a friend or relative at either Wave I or II. We examined the longitudinal association between past-week loneliness (exposure, captured at cohort entry) and suicidal ideation and attempt (outcomes, captured in subsequent waves, to Wave IV) among adolescents.

RESULTS

Loneliness was significantly associated with probability of later suicidal ideation (odds ratio [OR] = 1.95, 95% CI [1.46, 2.60], p < 0.001) and attempt (OR = 1.72, 95% CI [1.10, 2.68], p = 0.017), also when adjusted for sociodemographic variables (adjusted OR [AOR] = 2.01, 95% CI = [1.50, 2.68], p < 0.001; AOR = 1.76, 95% CI [1.11, 2.80], p = 0.016, respectively) but these associations were non-significant in our final models accounting for baseline depression (AOR = 1.17, 95% CI [0.83, 1.64], p = 0.377; AOR = 1.22, 95% CI [0.70, 2.11], p = 0.468, respectively). A priori interaction tests suggested that the influence of loneliness on suicidal ideation was more pronounced at one-year follow-up than after 6-13-year follow-up.

CONCLUSIONS

These findings emphasize the need for targeted strategies to address loneliness in adolescents who experience the suicidal behavior of a close contact, with a focus on proactive early intervention to address loneliness and depression to reduce suicidal distress.