Researchers created a new prediction tool to help doctors identify which young people with early-onset depression (starting before age 25) are at higher risk of attempting suicide. By studying data from patients between 2013 and 2023, scientists found that factors like smoking, drinking, education level, and certain blood markers could help predict suicide risk. The tool showed moderate accuracy in tests, but doctors say it needs more testing with larger groups of people before it can be widely used in hospitals and clinics.

The Quick Take

  • What they studied: Can doctors predict which young people with depression might try to hurt themselves by looking at their medical history, lifestyle habits, and blood test results?
  • Who participated: Young adults (age 25 and under) who were diagnosed with major depression between 2013 and 2023. The study compared those who had attempted suicide with those who hadn’t.
  • Key finding: A new prediction tool using 8 factors (including smoking, drinking, education, marital status, and blood markers) correctly identified suicide risk about 73% of the time—better than guessing, but not perfect.
  • What it means for you: This tool might help doctors spot young people with depression who need extra support and monitoring, but it’s not ready for regular use yet. It needs testing with more diverse groups of people first.

The Research Details

This was a retrospective study, meaning researchers looked back at medical records from patients who had already been treated. They gathered information from young adults (age 25 and under) diagnosed with major depression over a 10-year period (2013-2023). The researchers collected data on personal details (age, sex, job, education, marital status), lifestyle habits (smoking and drinking), and blood test results (folate, ACTH, and homocysteine levels). They then split patients into two groups: those who had attempted suicide and those who hadn’t. Using statistical methods, they identified which factors were most connected to suicide attempts and built a prediction model—like a scoring system doctors could use.

The researchers tested their model using a technique called 10-fold cross-validation, which is like checking your work multiple times to make sure it’s accurate. They also created a visual tool called a nomogram (a special chart) that doctors could use to estimate someone’s risk level based on their personal information and test results.

Early-onset depression (starting before age 25) is particularly serious because it tends to be more severe and long-lasting than depression that starts later in life. Young people with this type of depression have a higher risk of attempting suicide. If doctors could identify who is at highest risk, they could provide extra support, more frequent check-ins, and stronger treatments. This study tried to create a practical tool that uses information doctors already collect, making it potentially useful in real-world settings.

The study had several strengths: it used real patient data from a 10-year period, it compared two clearly defined groups, and it tested the model multiple times to check accuracy. However, there are important limitations: the study doesn’t specify the total number of participants, which makes it hard to judge how reliable the results are. The researchers acknowledge that the model needs testing with larger and more diverse populations before it can be trusted for regular clinical use. The moderate accuracy (73%) means it’s helpful but not perfect—some people at risk might be missed, and some people might be incorrectly identified as high-risk.

What the Results Show

The research team found several important differences between young people with depression who attempted suicide and those who didn’t. People who attempted suicide were more likely to smoke (21.1% vs. 8.8%) and drink alcohol (12.9% vs. 5.3%). They also had different education levels and lower folate levels (a B vitamin important for brain health). The depression in the suicide attempt group was more severe—more of these patients needed electroconvulsive therapy (a serious treatment for severe depression) and mood stabilizer medications.

The final prediction tool included eight key factors: sex, occupation, education level, marital status, tobacco use, alcohol consumption, and two blood markers (ACTH and folate levels). When tested, the tool correctly identified suicide risk about 73% of the time, which is better than random guessing but leaves room for improvement. The researchers used multiple testing methods to confirm these results were reliable.

The study revealed that lifestyle factors like smoking and drinking were strongly connected to suicide attempts in young people with depression. Education level and marital status also appeared important, suggesting that social and economic factors play a role in suicide risk. The blood markers (ACTH and folate) suggest that biological changes in the body during depression may also influence suicide risk. These findings together paint a picture that suicide risk in young people with depression involves a mix of personal circumstances, lifestyle choices, and body chemistry.

Previous research has shown that depression starting at a young age tends to be more serious and harder to treat. This study builds on that knowledge by trying to identify specific warning signs. While other studies have looked at suicide risk factors in depression, this research is unique because it combines lifestyle information, personal circumstances, and blood test results into one prediction tool. The moderate accuracy (73%) is similar to other prediction tools in psychiatry, suggesting this approach is reasonable but that predicting suicide attempts remains challenging.

The study has several important limitations that readers should understand. First, the exact number of participants isn’t clearly stated, making it hard to judge how reliable the findings are. Second, the tool only showed moderate accuracy (73%), meaning it misses some people at risk and incorrectly flags others. Third, the study only looked at patients from one time period and location, so the results might not apply to all young people with depression. Fourth, the researchers acknowledge the tool needs testing with larger, more diverse groups before doctors should use it regularly. Finally, this type of study can only show connections between factors and suicide attempts—it can’t prove that one thing causes another.

The Bottom Line

This research is preliminary and not yet ready for doctors to use in everyday practice. The findings suggest that doctors should pay special attention to young people with depression who smoke, drink alcohol, have lower education levels, or show certain blood marker changes. However, these should be considered as additional warning signs to watch for—not as a definitive prediction tool. Doctors should continue using their clinical judgment and established suicide risk assessment methods. Anyone with depression should talk openly with their doctor about suicidal thoughts, and family members should watch for warning signs like increased isolation, giving away possessions, or talking about death.

This research is most relevant to psychiatrists, mental health counselors, and doctors who treat young people with depression. It may also be important for hospital administrators and mental health organizations planning care for young patients. Young people with depression and their families should know that researchers are working to better understand and predict suicide risk, but this particular tool isn’t ready for personal use yet. Anyone struggling with suicidal thoughts should reach out to a mental health professional, trusted adult, or crisis hotline immediately.

If this tool is eventually validated and approved for clinical use, benefits would likely be seen immediately in terms of better identification of high-risk patients. However, the actual reduction in suicide attempts would depend on what treatments and support are offered to identified high-risk individuals. The researchers estimate that further validation studies could take 2-5 years before this tool might be ready for widespread use.

Want to Apply This Research?

  • Users could track weekly mood ratings (1-10 scale), substance use (cigarettes and alcohol consumption), sleep quality, and any suicidal thoughts or urges. This data could be reviewed with a healthcare provider to monitor trends over time.
  • The app could help users reduce modifiable risk factors by setting goals to decrease smoking and alcohol use, improve sleep, and maintain social connections. Users could receive reminders to reach out to support contacts or mental health professionals if they notice warning signs.
  • Implement a monthly check-in system where users review their tracked data with a mental health professional. The app could flag concerning patterns (increased substance use, worsening mood, social isolation) and suggest reaching out for help. Users should also maintain regular appointments with their doctor for blood work monitoring.

This research describes a preliminary prediction tool that is not yet approved for clinical use. It should not be used for self-diagnosis or to replace professional mental health evaluation. If you or someone you know is experiencing suicidal thoughts, please contact a mental health professional, call the National Suicide Prevention Lifeline (988 in the US), or go to the nearest emergency room immediately. This study shows associations between certain factors and suicide attempts but does not prove these factors cause suicide attempts. Always consult with a qualified healthcare provider about depression treatment and suicide risk assessment. The findings apply specifically to young people (age 25 and under) with early-onset major depression and may not apply to other populations.