Importance  Community-based studies have linked psychotic experiences (PEs) with increased risks of suicidal thoughts and behaviors (STBs). However, it is not known if these associations vary across the life course or if mental disorders contribute to these associations.

Objective  To examine the temporal association between PEs and subsequent STBs across the life span as well as the influence of mental disorders (antecedent to the STBs) on these associations.

Design, Setting, and Participants  A total of 33 370 adult respondents across 19 countries from the World Health Organization World Mental Health Surveys were assessed for PEs, STBs (ie, ideation, plans, and attempts), and 21 DSM-IV mental disorders. Discrete-time survival analysis was used to investigate the associations of PEs with subsequent onset of STBs.

Main Outcomes and Measures  Prevalence and frequency of STBs with PEs, and odds ratios and 95% CIs.

Results  Of 33 370 included participants, among those with PEs (n = 2488), the lifetime prevalence (SE) of suicidal ideation, plans, and attempts was 28.5% (1.3), 10.8% (0.7), and 10.2% (0.7), respectively. Respondents with 1 or more PEs had 2-fold increased odds of subsequent STBs after adjusting for antecedent or intervening mental disorders (suicidal ideation: odds ratio, 2.2; 95% CI, 1.8-2.6; suicide plans: odds ratio, 2.1; 95% CI, 1.7-2.6; and suicide attempts: odds ratio, 1.9; 95% CI, 1.5-2.5). There were significant dose-response relationships of number of PE types with subsequent STBs that persisted after adjustment for mental disorders. Although PEs were significant predictors of subsequent STB onset across all life stages, associations were strongest in individuals 12 years and younger. After adjustment for antecedent mental disorders, the overall population attributable risk proportions for lifetime suicidal ideation, plans, and attempts associated with temporally prior PEs were 5.3%, 5.7%, and 4.8%, respectively.

Conclusions and Relevance  Psychotic experiences are associated with elevated odds of subsequent STBs across the life course that cannot be explained by antecedent mental disorders. These results highlight the importance of including information about PEs in screening instruments designed to predict STBs.

重要性  基于社区的研究已将精神病经历（PE）与自杀念头和行为（STB）的风险增加联系起来。但是，尚不清楚这些关联在整个生命过程中是否发生变化，或者精神障碍是否促成这些关联。

目的  研究整个生命周期中PE与后续STB之间的时间关联，以及精神障碍（STB之前）对这些关联的影响。

设计，设置和参与者  来自世界卫生组织世界心理健康调查的19个国家/地区的33 370名成年受访者接受了PE，STB（即构想，计划和尝试）和21种DSM - IV精神障碍的评估。离散时间生存分析用于研究PE与STB随后发作的关联。

主要结果和措施  带有PE的STB的患病率和频率，比值比和95％CI。

结果  在33 370名参与者中，有PE（n = 2488）的参与者中，自杀意念，计划和尝试的终生患病率（SE）为28.5％（1.3），10.8％（0.7）和10.2％（0.7），分别。具有1个或多个PE的受访者在对先前或干预的精神障碍进行调整后，其后STB的机率增加了2倍（自杀意念：优势比为2.2; 95％CI为1.8-2.6;自杀计划：优势比为2.1; 95％ CI：1.7-2.6；自杀未遂：胜算比：1.9； 95％CI：1.5-2.5）。调整精神障碍后，PE类型数量与随后的STB之间存在显着的剂量反应关系。尽管PEs是所有生命阶段随后STB发作的重要预测指标，但在12岁以下的个体中关联性最强。调整了先前的精神障碍后，

结论与相关性  精神病经历与整个生命过程中随后的机顶盒患病几率增加有关，这不能用先前的精神障碍来解释。这些结果凸显了在用于预测机顶盒的筛查仪器中包括有关PE的信息的重要性。