Swanson, SonjaColman, Ian2017-07-182017-07-182013Swanson SA, Colman I. Association between exposure to suicide and suicidality outcomes in youth. CMAJ. 2013 Jul 9;185(10):870-7.http://www.cmaj.ca/content/early/2013/05/21/cmaj.121377http://hdl.handle.net/10393/36355https://doi.org/10.20381/ruor-20635Background: Ecological studies support the popularized hypothesis that suicide may be “contagious”, in that exposure to suicide may influence risk for suicide and related outcomes. However, this association has not been assessed adequately in prospective studies. The purpose of this study was to estimate the association between exposure to suicide and suicidality outcomes in Canadian youth. Methods: The study used baseline information from the National Longitudinal Survey of Children and Youth (NLSCY) between 1998/99 and 2006/07 with follow-up assessments two years later. Participants included all respondents aged 12-17 in Cycles 3-7 (1998/99-2006/07) with measures on suicide exposures (N=8,766 ages 12-13; N=7,802 ages 14-15; N=5,496 ages 16-17). Results: Exposure to a schoolmate’s suicide was associated with ideation at baseline in ages 12-13 (OR=5.06; 95%CI: 3.04-8.40), 14-15 (OR=2.93; 95%CI: 2.02-4.24), and 16-17 (OR=2.23; 95%CI: 1.43-3.48); it was further associated with attempts in ages 12-13 (OR=4.57; 95%CI: 2.39-8.71), 14-15 (OR=3.99; 95%CI: 2.46-6.45), and 16-17 (OR=3.22; 95%CI: 1.62-6.41). Personally knowing someone who died by suicide was similarly associated with suicidality outcomes for all age groups. Two-year outcomes were assessed for ages 12-15; a schoolmate’s suicide predicted suicide attempts in both 12-13 (OR=3.07; 95%CI: 1.05-8.96) and 14-15 year-olds (OR=2.72; 95%CI: 1.47-5.04). Among those who reported a schoolmate’s suicide, whether the respondent personally knew the decedent did not alter suicidality risk. Interpretation: These results generally support school-wide over current targeted interventions, particularly over strategies that suggest targeting interventions toward those closest to the decedent.ensuicidesuicide contagionArticle10.1503/cmaj.121377