BACKGROUND:Emergency laparotomy (EmLap) is a high-risk surgery for acute abdominal conditions. This study uses a retrospective mixed-methods approach to explore quality of life and patient-reported outcomes and experiences (PROMs and PREMs) among EmLap survivors. METHODS:Patients who underwent EmLap from 2016-2019 at a tertiary hospital were surveyed, with demographic and clinical data collected from institutional National Emergency Laparotomy Audit (NELA) databases. Outcomes included QoL (EQ-5D-5L), employment, sexual function, incisional hernias, peri-operative anxiety, body image, and overall patient experience. The themes explored in the questionnaire were developed based on findings from previous studies of EmLap survivorship. Thematic analysis was conducted for qualitative responses, alongside statistical analysis for quantitative data. RESULTS:A total of 725 eligible patients were identified, and 310 responses were returned (42.8% response rate). Mean length of follow up was 33 months (range 6-54 months). Regression analysis confirmed QoL was associated with higher socioeconomic status (coefficient 0.047, p < 0.001), reduced BMI (coefficient -0.009, p < 0.05) and reduced ASA (coefficient -0.070, p < 0.05). Nearly half of respondents were retired at the time of surgery; among those who were employed, 40.5% experienced changes in employment which included earlier retirement. Recovery of sexual function was delayed, with 11.3% of patients reporting they had not resumed sexual activity post-surgery. Incisional hernia was reported by 38.9% of respondents, and 34.0% expressed dissatisfaction with body image. Free-text responses revealed unmet needs for mental health support (22.6%), dietary guidance (10.3%), and physiotherapy (15.8%). CONCLUSION:These findings highlight the physical, psychological, and socioeconomic burden faced by patients after EmLap, and support the need for tailored post-operative support systems to be integrated into post-operative care.

Background: Dropout rates and factors contributing to dropout in drug and placebo groups in pharmacotherapy trials for posttraumatic stress disorder (PTSD) are not well understood.Objective: This study aimed to examine differences in all-cause study dropouts between drug and placebo groups, using conventional meta-analysis and an exploratory predictor analysis of individual participant data from three trials.Method: We included randomized controlled trials (RCTs) of adults with PTSD, comparing drug monotherapy with placebo. Forty-three RCTs (n = 4829) were included in a conventional meta-analysis. Additionally, we conducted a small exploratory predictor analysis including participant-level data from three RCTs (n = 246).Results: In the conventional meta-analysis, study dropout was marginally lower in the drug relative to the placebo group, but the difference was not significant, RR = 0.92, 95% CI [0.83, 1.02], p = .099. Drug class, dosing regimen, population, study duration, or gender were not related to dropout.In the exploratory predictor analysis, study dropout did not differ significantly between drug and placebo groups (p = .617). In the drug group, gender was a significant predictor for dropout, with males having higher dropout rates (p = .046). When controlling for baseline PTSD symptom severity, gender was no longer a statistically significant predictor (p = .051). None of the other predictors in drug, placebo, and combined group analyses were significant in predicting drop-out.Conclusions: This study demonstrated that study dropout rates in monotherapy pharmacotherapy RCTs for PTSD do not significantly differ between drug and placebo groups. These findings underscore the need for further research to identify the factors contributing to dropout in PTSD pharmacotherapy trials and to develop tailored treatment adherence strategies. Additionally, they highlight the importance of pooling participant-level data to facilitate more comprehensive and granular analyses in future research.

Background: The International Trauma Interview (ITI) is a structured clinician-administered measure developed to assess posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined in the 11th version of the International Classification of Diseases (ICD-11). This study aimed to investigate a psychometric evaluation of the ITI and to finalise the English language version.Method: The latent structure, internal consistency, interrater agreement, and convergent and discriminant validity were evaluated with data from a convenience sample, drawn from an existing research cohort, of 131 trauma exposed participants from the United Kingdom reporting past diagnosis for PTSD or who had screened positively for traumatic stress symptoms. A range of self-report measures evaluating depression, panic, insomnia, dissociation, emotion dysregulation, negative cognitions about self, interpersonal functioning and general wellbeing were completed.Results: Confirmatory factor analysis supported an adjusted second-order two-factor model of PTSD and disturbances in self-organisation (DSO) symptoms, allowing affect dysregulation to also load onto the PTSD factor, over alternative models. The ITI scores showed acceptable internal consistency, and interrater reliability was strong. Findings for convergent and discriminant validity were mostly as predicted for PTSD and DSO domains. Correlations with the ITQ were good but coefficients for the level of agreement of PTSD diagnosis and CPTSD diagnosis between the ITI and the ITQ were weaker, and item level agreement was variable.Conclusion: Results provide support for the reliability and validity of the ITI as a measure of ICD-11 PTSD and CPTSD. Final revisions of the ITI are described.

OBJECTIVE:This individual participant data meta-analysis aimed to investigate the effectiveness of cognitive behavioral therapy with a trauma focus (CBT-TF) for posttraumatic stress disorder (PTSD). Furthermore, we examined the effect of moderators on PTSD symptom severity. METHOD:This study included randomized controlled trials comparing CBT-TF to an inactive or active comparison group for adults with PTSD. The primary and secondary outcomes were PTSD symptom severity and remission, respectively. Moderators included sociodemographic and clinical variables. RESULTS:Twelve studies compared CBT-TF with inactive (n = 625) and 11 with active comparison conditions (n = 706). The one-stage individual participant data meta-analysis found that CBT-TF was more effective than inactive comparison conditions (β = -0.78; OR = 2.34) and not significantly different from active comparison conditions (β = 0.02; OR = 0.53) in reducing PTSD symptom severity and achieving PTSD remission, respectively. When comparing CBT-TF with inactive treatments, moderator analysis found that divorced participants had greater PTSD symptoms postintervention following CBT-TF than participants who were single, cohabitating, or married receiving CBT-TF, both in the completer (β = 0.93) and full-sample (β = 0.59) analyses. For the active treatment comparison, moderator analysis found that participants taking psychotropic medication had lower PTSD symptoms following CBT-TF than those not taking psychotropic medication in the completer analysis (β = -0.39). CONCLUSION:Based on our moderator analyses, further research is needed to understand the effect of psychotropic medication on the CBT-TF intervention process. Moreover, divorced participants with PTSD receiving CBT-TF might benefit from enhanced support. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Prolonged Grief Disorder (PGD) is characterised by persistent longing or preoccupation with a deceased loved one, accompanied by intense emotional pain that lasts six-months or more and significantly impairs functioning. While Cognitive Behavioural Therapy (CBT) with a grief focus is effective, access is limited due to high costs and therapist shortages. Guided digital therapy, which delivers psychological support via an app or website with professional guidance, may offer a scalable solution. Building on the success of a guided digital intervention for post-traumatic stress disorder (PTSD), this study evaluates a similar intervention for PGD in a UK-based randomised controlled trial (RCT).Objective: This study aims to assess the acceptability and feasibility of Spring PGD, a co-produced guided digital therapy for PGD, in preparation for a future definitive RCT.Methods: This exploratory, randomised, parallel-group controlled trial will allocate 42 participants in a 1:1 ratio to either immediate access to Spring PGD or a waiting list control group. After 11 weeks, control participants will cross over to receive Spring PGD. The primary outcome measure is the Prolonged Grief 13 Revised (PG-13-R). A nested process evaluation will explore fidelity, adherence, and programme theory through interviews with purposively sampled participants and therapists.Results: Findings will provide preliminary data on the acceptability, engagement, and feasibility of Spring PGD, informing the design of a future definitive RCT.Conclusions: If Spring PGD shows promise, it could offer an accessible, scalable treatment for PGD, particularly in areas with limited access to specialised mental health services. The results will contribute to understanding the potential of guided digital therapy in addressing gaps in PGD treatment.

Rare copy number variants (CNVs) are a key component of the genetic basis of psychiatric conditions, but have not been well characterized for most. We conducted a genome-wide CNV analysis across six diagnostic categories (N = 574,965): autism (ASD), ADHD, bipolar disorder (BD), major depressive disorder (MDD), PTSD, and schizophrenia (SCZ). We identified 35 genome-wide significant associations at 18 loci, including novel associations in SCZ ( SMYD3, USP7 - HAPSTR1 ) and in the combined cross-disorder analysis ( ASTN2 ). Rare CNVs accounted for 1-3% of heritability across diagnoses. In ASD, associations were uniformly positive, consistent with autism having diverse etiologies and clinical presentations. By contrast, CNVs showed a dose-dependent relationship for other diagnoses, including SCZ and PTSD, with reciprocal deletions and duplications having inversely correlated effects and distinct genotype-phenotype relationships. Our findings suggest that genes have effects that are both dose-dependent and pleiotropic, such that a positive influence on one dimension of psychopathology may be accompanied by positive or negative effects on others.

Introduction Young people (YP) whose parents have depression are at elevated risk for developing depression themselves and could benefit from preventive interventions. However, when parents are in a depressive episode, this reduces the effects of psychological interventions for depression in YP. Moreover, parental depression is often managed suboptimally in usual care. There is, therefore, a case for identifying and optimising parental depression treatment to enhance the effectiveness of psychological preventive interventions for depression in YP.Methods and analysis This is a randomised controlled trial (Skills for adolescent WELLbeing) to determine the effectiveness of a cognitive behavioural therapy (CBT) intervention compared with usual care in increasing the time to a major depressive episode in YP by 9-month follow-up (primary outcome). The intervention offers a 12-week treatment-optimisation phase for parents depressed at study entry, followed by randomisation of the young person to a small group manualised online CBT programme facilitated by a therapist. YP allocated to the intervention will receive eight weekly sessions plus three monthly continuation sessions. Secondary outcomes include the number of depression-free weeks, mental health symptoms and functioning. Mechanisms of intervention action will be assessed with mediation analysis of quantitative data and thematic analysis of qualitative interviews. Participants (parents/carers with depression and their children aged 13–19 years) will be identified through existing cohorts of adults with depression, from primary care through health boards in Wales and England, UK, schools and advertising including via social media.Ethics and dissemination The trial has received ethical approval from Wales NHS Research Ethics Committee (REC) 5, the Health Research Authority and Health and Care Research Wales (IRAS 305331; REC 22/WA/0254). This manuscript is based on V.5.7 of the protocol (17 January 2025). Findings will be disseminated in peer-reviewed journals and conferences. Reports and social media messages will be used to disseminate findings to the wider public.Trial registration number ISRCTN13924193 (date registered: 15 March 2023).

Potrauminio streso sutrikimas (PTSS) yra paplitusi psichikos sveikatos problema, tačiau tik dalis šį sutrikimą turinčių žmonių gauna tinkamą psichologinę pagalbą. Internetu teikiamos psichologinės intervencijos galėtų tapti lengviau prieinama ir pigesne alternatyva įprastiems psichologinės pagalbos būdams. „Spring“ – tai Kardifo universiteto (Jungtinė Karalystė) mokslininkų sukurta į traumą orientuotos kognityvinės elgesio terapijos principais grįsta psichologinė internetu teikiama savigalbos intervencija. „Spring“ skirta vidutinio sunkumo potrauminio streso sutrikimo simptomams išgyvenus vienkartines traumines patirtis mažinti ir yra taikoma įsitraukus psichologui. Šio bandomojo tyrimo tikslas – įvertinti PTSS turinčių asmenų psichologinės savijautos pokyčius pasinaudojus „Spring“ intervencinės programos lietuviškąja versija. Šiam tikslui pasiekti buvo analizuoti septynių TLK-11 potrauminio streso sutrikimą turinčių moterų, dalyvavusių „Spring“ intervencijoje, duomenys. Tyrimo dalyvių amžiaus vidurkis buvo 41 m. (SD = 15). Naudota vienos grupės, kai įvertinama prieš intervenciją ir po jos, tyrimo schema. Savijauta vertinta Tarptautiniu traumos klausimynu (ITQ), Tarptautiniu depresijos klausimynu (IDQ), Tarptautiniu nerimo klausimynu (IAQ) ir PSO psichologinės gerovės indeksu (WHO-5). Duomenų analizei naudotas Wilcoxono kriterijus ir patikimo pokyčio indeksas (RCI). Rezultatai atskleidė, jog po „Spring“ intervencijos reikšmingai sumažėjo tyrimo dalyvių potrauminis stresas, depresijos ir nerimo simptomai, o psichologinės gerovės rodiklis padidėjo. Visų dalyvių PTSS simptomų sumažėjimas buvo statistiškai patikimas, o šešios iš septynių dalyvių po intervencijos nebepriklausė PTSS rizikos grupei. Bendras pasitenkinimas gauta pagalba buvo didelis. Pirmieji „Spring“ internetu teikiamos intervencijos lietuviškos versijos žvalgomojo tyrimo rezultatai rodo, kad ši pagalbos programa gali būti daug žadantis būdas gydyti potrauminio streso sutrikimą. Siekiant įvertinti šios intervencijos veiksmingumą, svarbu atlikti atsitiktinių imčių kontroliuojamus tyrimus surinkus didesnių imčių.

The understanding of responses to traumatic events has been greatly influenced by the introduction of the diagnosis of post-traumatic stress disorder (PTSD). In this paper we review the initial versions of the diagnostic criteria for this condition and the associated epidemiological findings, including sociocultural differences. We consider evidence for post-traumatic reactions occurring in multiple contexts not previously defined as traumatic, and the implications that these observations have for the diagnosis. More recent developments such as the DSM-5 dissociative subtype and the ICD-11 diagnosis of complex PTSD are reviewed, adding to evidence that there are several distinct PTSD phenotypes. We describe the psychological foundations of PTSD, involving disturbances to memory as well as to identity. A broader focus on identity may be able to accommodate group and communal influences on the experience of trauma and PTSD, as well as the impact of resource loss. We then summarize current evidence concerning the biological foundations of PTSD, with a particular focus on genetic and neuroimaging studies. Whereas progress in prevention has been disappointing, there is now an extensive evidence supporting the efficacy of a variety of psychological treatments for established PTSD, including trauma-focused interventions - such as trauma-focused cognitive behavior therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) - and non-trauma-focused therapies, which also include some emerging identity-based approaches such as present-centered and compassion-focused therapies. Additionally, there are promising interventions that are neither psychological nor pharmacological, or that combine a pharmacological and a psychological approach, such as 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. We review advances in the priority areas of adapting interventions in resource-limited settings and across cultural contexts, and of community-based approaches. We conclude by identifying future directions for work on trauma and mental health.

Background: Prolonged Grief Disorder (PGD) affects a significant minority of bereaved individuals, leading to persistent emotional distress and functional impairment for six months or more. While cognitive behavioural therapy (CBT) with a grief specific focus is effective, access is limited due to the resource demands of in-person therapy. Guided digital therapies offer a promising alternative, but research on their use in the UK remains limited.Objective: This study aimed to develop a guided digital therapy for PGD using a co-production approach that engaged both individuals with relevant lived experience and professionals specialising in grief-related mental health. The goal was to design a user-centred, evidence-informed intervention to improve access to PGD treatment.Method: The development process followed a multi-stage approach. First, rapid literature reviews were conducted to assess existing evidence on in-person and digital therapies for PGD. Second, qualitative interviews were held with stakeholders, including individuals with lived experience of PGD and professionals in grief and/or digital interventions. The interviews gathered opinions on intervention content, structure, and delivery. Inductive thematic analysis was used to identify key themes, which informed the intervention design.Results: Five key themes emerged: (1) acceptability of digital interventions for PGD, (2) challenges in adjusting to loss and finding meaning, (3) optimal timing for therapy, (4) the need for simplicity in intervention delivery, and (5) strategies for effective user engagement. These insights guided the development of a practical, accessible, and engaging intervention.Conclusions: The co-production process led to the development of a guided digital therapy for PGD, incorporating perspectives from both individuals with lived experience and professionals. This study highlights the importance of cultural sensitivity, user engagement, and simplicity in digital intervention design. Findings will inform the next steps in evaluating and refining the intervention to enhance access to PGD treatment in the UK and beyond.

Post-traumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 new). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (for example, GRIA1, GRM8 and CACNA1E), developmental, axon guidance and transcription factors (for example, FOXP2, EFNA5 and DCC), synaptic structure and function genes (for example, PCLO, NCAM1 and PDE4B) and endocrine or immune regulators (for example, ESR1, TRAF3 and TANK). Additional top genes influence stress, immune, fear and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation. Multi-ancestry genome-wide analyses identify 95 loci associated with post-traumatic stress disorder and implicate candidate genes, pathways and neurobiological systems underlying its pathophysiology.

Abstract Aims Recent work demonstrated 8% of emergency laparotomy (EmLap) survivors were referred to mental health following surgery, suggesting it carries a significant psychological burden. This exploratory work aims to describe patients’ psychological response 1 year after EmLap using a qualitative approach. Methods POLO is a prospective cohort multicentre, mixed methods study on EmLap patients. (IRAS 301310, ClinicalTrials.Gov NCT05281627). Purposive sampling identified a subgroup to undergo 2 semi-structured interviews at 6 and 12-months post-discharge, either in person/videoconferencing, using a pre-formulated topic guide. Interviews were recorded, transcribed verbatim, and analysed using Braun and Clark’s six-step approach. Results 12 participants provided interviews at both time points. 75% were female; average age was 52 years. Patients underwent significant psychological adjustment following EmLap, similar to the Kuber-Ross Grief Reaction model; transitioning through shock, anger, bargaining, depression to eventual acceptance. Patients’ recollection of early response was disbelief, followed by anger towards their care. Bargaining centred around having restorative surgery. Depression was exacerbated by physical issues; fatigue, stoma stigma and ongoing medical treatment. Most patients reached acceptance stage by the 12-month interview. Conclusion This is the first study to describe the psychological response following EmLap. This work parallels the psychological response with other significant traumatic events, such as grief. These findings may suggest that the negative effect on patients’ mental health following surgery, observed by an increase in referral, are part of a “normal” trajectory, rather than pathological. More work is needed to understand how, and when, the response becomes problematic to functioning and long-term wellbeing.

Introduction Morbidity from an emergency laparotomy (EmLap) is difficult to define and poorly understood. Morbidity is a holistic concept, reliant upon an interplay of bio-psychosocial outcomes that evolve long after discharge. To date, no previous study has explored the psychosocial outcomes following EmLap as a collective, nor their change over time. This study aims to describe the holistic morbidity following EmLap within the first year following surgery.Methods and analysis This is a multicentre, mixed-methods prospective 12-month cohort study with two participant populations: patient participants and family caregivers (FCGs). A target of 160 adult patients who undergo EmLap and can give informed consent will be included in the patient participant group. Patient participants will be asked to complete three patient surveys, incorporating validated patient-reported outcome measures (PROMs) to assess bio-psychosocial outcomes (EuroQol five-dimension five-level (EQ5D-5L), Gastrointestinal Quality Life Index-36, Patient Health Questionnaire-9, Generalised Anxiety Disorder 7, International Trauma Questionnaire, Caregiver Interaction Scale and Fatigue Severity Scale) in the 12 months following surgery. A subgroup of 15 patient participants will be asked to take part in two semistructured interviews at 6 and 12 months. A target of 15 associated family caregivers will be included in the FCG group. FCGs will be asked to take part in a semi-structured interview at 6 months to assess the EmLap impact on the wider support network. The primary outcome will be a change in quality of life (EQ5D-5L) at 12 months. Secondary outcomes will be changes in bio-psychosocial status at 3 and 12 months. Qualitative analysis will allow contextualisation of PROMS and further explore themes of EmLap morbidity. It is anticipated that the results of this study will help inform and develop standards of aftercare for future EmLap patients.Ethics and dissemination This study has received ethical approval (Wales REC7;12/WA/0297) and will be undertaken in accordance with the principles of Good Clinical Practice. We intend to disseminate study results in peer-reviewed journals and medical conferences, as well as a lay report to study participants.Trial registration number Clinical Trials.gov NCT05281627.

Background Available empirical evidence on participant-level factors associated with dropout from psychotherapies for post-traumatic stress disorder (PTSD) is both limited and inconclusive. More comprehensive understanding of the various factors that contribute to study dropout from cognitive-behavioural therapy with a trauma focus (CBT-TF) is crucial for enhancing treatment outcomes.Objective Using an individual participant data meta-analysis (IPD-MA) design, we examined participant-level predictors of study dropout from CBT-TF interventions for PTSD.Methods A comprehensive systematic literature search was undertaken to identify randomised controlled trials comparing CBT-TF with waitlist control, treatment-as-usual or another therapy. Academic databases were screened from conception until 11 January 2021. Eligible interventions were required to be individual and in-person delivered. Participants were considered dropouts if they did not complete the post-treatment assessment.Findings The systematic literature search identified 81 eligible studies (n=3330). Data were pooled from 25 available CBT-TF studies comprising 823 participants. Overall, 221 (27%) of the 823 dropped out. Of 581 civilians, 133 (23%) dropped out, as did 75 (42%) of 178 military personnel/veterans. Bivariate and multivariate analyses indicated that military personnel/veterans (RR 2.37) had a significantly greater risk of dropout than civilians. Furthermore, the chance of dropping out significantly decreased with advancing age (continuous; RR 0.98).Conclusions These findings underscore the risk of premature termination from CBT-TF among younger adults and military veterans/personnel.Clinical implication Understanding predictors can inform the development of retention strategies tailored to at-risk subgroups, enhance engagement, improve adherence and yield better treatment outcomes.

BackgroundPosttraumatic stress disorder (PTSD) is a common mental disorder. However, many cases of PTSD remain untreated because of limited healthcare resources and other treatment-seeking barriers. Effective internet-based interventions could help to improve access to PTSD treatments. Therefore, the main objective of the planned randomized controlled trial is to evaluate the efficacy of the Lithuanian version of the guided internet-based self-help programme (Spring) in reducing ICD-11 PTSD symptoms.MethodsThe planned sample size is 50 participants exposed to different traumatic experiences. Participants eligible for the study will be randomized into two study groups: the immediate treatment group and the delayed treatment control group. Both groups will receive guided trauma-focused ICBT intervention, but the delayed treatment group will receive access to the programme five months after randomization. The International Trauma Interview (ITI) will be used for the assessment of ICD-11 PTSD symptoms at pre-treatment, post-treatment, and at a 3-month follow-up. Changes in disturbances in self-organization, depression and anxiety levels, as well as posttraumatic cognitions and trauma-related shame, will also be evaluated. In addition, associations between changes in symptoms of PTSD and readiness for treatment, treatment expectations and working alliance will be explored. Changes in treatment outcomes will be evaluated using multiple Latent Change Models.DiscussionThis study is expected to contribute to valuable knowledge on the efficacy of internet-based interventions for posttraumatic stress disorder.Trial registrationClinicalTrials.gov NCT06475716. Registered on 25 June 2024.

Background Childhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed. Aim To determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide. Method Population-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use). Results Records were extracted for 2477 ‘cases’ and 24 777 ‘controls’; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10–17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4–3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7–7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aORmale = 8.17 (95% CI, 5.02–13.29), aORfemale = 15.08 (95% CI, 8.07–28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aORmale = 1.90 (95% CI, 1.64–2.21), aORfemale = 2.65 (95% CI, 1.94–3.62), and each mental health admission by aORmale = 2.06 (95% CI, 1.81–2.34), aORfemale = 1.78 (95% CI, 1.50–2.10). Conclusions Our lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential ‘at-risk’ adolescents to prevent future suicidal acts, especially those in general hospitals.