Associations between depressive symptoms with suicide behaviors and negative relationships with mother and father in early adolescents: a population-based study.

Background: Adolescent-parent negative relationships may favour depressive symptoms only (DSonly) and more strongly those plus suicide ideation (DSSI) or attempt (DSSA) in early adolescents (10-16 years). We assessed their associations which remain poorly addressed.

Methods: This study included 1256 middle-school adolescents from north-eastern France (mean age 13.5±1.3). They completed a questionnaire gathering socioeconomic features, academic performance, substance (alcohol, tobacco, cannabis and other substances) use, relationships with father and mother, depressive symptoms, last-12-month suicide ideation, and lifetime suicide attempt. For depressive symptoms and suicide attempt, the time of the first occurrence during adolescent's life course was also gathered. Data were analyzed using multinomial logistic regression models and Kaplan-Meier survival estimates.

Results: Many adolescents suffered from DSonly (8.0%), DSSI (2.5%) and DSSA (3.9%) and from negative relationships with father only (NRfather, 11.2%), mother only (NRmother, 6.1%), and both parents (NRboth parents, 10.9%). DSSA was more strongly associated (P<0.001) with NRmother (sex-age-adjusted odds ratio saOR=14.34) and NRboth parents (saOR=12.15) than NRfather (saOR=4.57). Similar results were found for DSSI (saOR 12.90, 12.23 and 2.16, respectively) and DSonly (saOR 4.18, 4.84 and 3.18, respectively). These results remained strong when controlling for socioeconomic features, academic performance and substance use (contribution reaching 62%). The risk early began and then steadily increased over time.

Conclusions: Adolescent-parent negative relationships favor DSonly and more strongly DSSI and DSSA. Mother had a much higher role than father. The role and support of both parents should be considered for prevention and care to reduce adolescents' mental health difficulties.