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Population-attributable risk of psychiatric disorders for suicide among adolescents and young adults in Taiwan

Published online by Cambridge University Press:  09 November 2022

Yi-An Hung
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
Shih-Cheng Liao
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan Department of Psychiatry, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu Hospital, Hsin-Chu City, Taiwan
Chia-Ming Chang
Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
Shu-Sen Chang
Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan
Albert C. Yang
Digital Medicine Center / Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
Yi-Ling Chien
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan
Chi-Shin Wu*
Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
Susan Shur-Fen Gau
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan Department of Psychology, Graduate Institute of Epidemiology, and Preventive Medicine, and Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
Author for correspondence: Chi-Shin Wu, E-mail:



Youth suicide rates have increased markedly in some countries. This study aimed to estimate the population-attributable risk of psychiatric disorders associated with suicide among Taiwanese youth aged 10–24 years.


Data were obtained from the National Death Registry and National Health Insurance (NHI) claims database between 2007 and 2019. Youth who died by suicide were included, and comparisons, 1:10 matched by age and sex, were randomly selected from the Registry for NHI beneficiaries. We used multivariable logistic regression to estimate suicide odds ratios for psychiatric disorders. The population-attributable fractions (PAF) were calculated for each psychiatric disorder.


A total of 2345 youth suicide and 23 450 comparisons were included. Overall, 44.8% of suicides had a psychiatric disorder, while only 7.9% of the comparisons had a psychiatric disorder. The combined PAF for all psychiatric disorders was 55.9%. The top three psychiatric conditions of the largest PAFs were major depressive disorder, dysthymia, and sleep disorder. In the analysis stratified by sex, the combined PAF was 45.5% for males and 69.2% for females. The PAF among young adults aged 20–24 years (57.0%) was higher than among adolescents aged 10–19 years (48.0%).


Our findings of high PAF from major depressive disorder, dysthymia, and sleep disorder to youth suicides suggest that youth suicide prevention that focuses on detecting and treating mental illness may usefully target these disorders.

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Copyright © The Author(s), 2022. Published by Cambridge University Press

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