doi:10.1016/j.psychres.2025.116555engMortier, PhilippeYang, XueAltwaijri, Yasmin A.Holdcraft, Jacob A.Lee, SueSampson, Nancy AAlbor, YesicaAlhadi, Ahmad N.Alonso, JordiAl-Saud, Nouf K.Andersson, ClaesAtwoli, LukoyeAuerbach, Randy P.Muaka, Caroline AyuyaBáez-Mansur, Patricia M.Ballester, LauraBantjes, JasonBaumeister, HaraldBendtsen, MarcusBenjet, CorinaBerman, Anne H.Bruffaerts, RonnyCarrasco, PaulaChan, Silver C.N.Cohut, IrinaCovarrubias Díaz Couder, María AnabellCrockett, Marcelo A.Cuijpers, PimDavid, Oana A.Dong, DongEbert, David D.Gaete, JorgeFelez-Nobrega, MireiaGarcía Forero, CarlosGili, MargalidaGutiérrez-García, Raúl A.Haro, Josep MariaHasking, PenelopeHunt, XantheHusky, Mathilde M.Jaguga, FlorenceJansen, LeontienLanger, Álvaro I.Liu, YanMac-Ginty, ScarlettMartínez, VaniaMason, AndreMathai, MuthoniMcLafferty, MargaretMiranda-Mendizabal, AndreaMurray, Elaine K.Musyoka, Catherine M.O’Neill, Siobhan M.Papasteri, Claudiu C.Piqueras, José A.Popescu, Codruta A.Rapsey, CharleneRobinson, KealaghRodriguez-Jimenez, TiscarScarf, DamianSiu, Oi-lingStein, Dan J.Struijs, Sascha Y.Tomoiaga, Cristina T.Valdés-García, Karla PatriciaVereecke, ShelbyVigo, Daniel V.Wang, Angel Y.Wong, Samuel Y.S.Kessler, Ronald C.The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student InitiativeART-2025-144306Objective. To investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students. Method. Poisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes. Results. Lifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4–7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5–7.7]), followed by MDx (RR range 1.3–3.0). Of the demographic subgroups, transgender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3–2.6]; ideation-to-attempt transition RR=1.5 [1.3–1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9–2.2]), major depressive disorder (RR=2.0 [1.9–2.1]), and bipolar disorder (RR=1.8 [1.6–2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3–1.7]), bipolar disorder (RR=1.4 [1.2–1.7]), and sexual abuse (RR=1.4 [1.2–1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0–1.8]). Conclusion. CAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.2025http://zaguan.unizar.es/record/16105910.1016/j.psychres.2025.116555http://zaguan.unizar.es/record/161059oai:zaguan.unizar.es:161059info:eu-repo/grantAgreement/ES/ISCIII/AC2-00006info:eu-repo/grantAgreement/ES/ISCIII/CB06-02-0046info:eu-repo/grantAgreement/ES/ISCIII/CP21-00078info:eu-repo/grantAgreement/ES/ISCIII/PI20-00006info:eu-repo/grantAgreement/ES/ISCIII/PI22-00107PSYCHIATRY RESEARCH 350 (2025), 116555 [13 pp.]byhttps://creativecommons.org/licenses/by/4.0/deed.esinfo:eu-repo/semantics/openAccess