The impact of lifetime suicidality on academic performance in college freshmen.

BACKGROUND While suicidal thoughts and behaviors (STB) among college students are common, the associations between STB and academic performance are not well understood. METHODS As part of the World Mental Health Surveys International College Student project, web-based self-reported STB of KU Leuven (Leuven, Belgium) incoming freshmen (N=4921; response rate=65.4%) was collected, as well as academic year percentage (AYP), and the departments to which students belong. Single- and multilevel multivariate analyses were conducted, adjusted for gender, age, parental educational level, and comorbid lifetime emotional problems. RESULTS Lifetime suicide plan and attempt upon college entrance were associated with significant decreases in AYP (3.6% and 7.9%, respectively). A significant interaction was found with average departmental AYP, with STB more strongly associated with reduced AYP in departments with lower than higher average AYP. LIMITATIONS Limited sample size precluded further investigation of interactions between department-level and student-level variables. No information was available on freshman secondary school academic performance. CONCLUSIONS Lifetime STB has a strong negative association with academic performance in college. Our study suggests a potential role for the college environment as target for treatment and prevention interventions.