OBJECTIVES: To examine predictive power of psychache and life satisfaction on risks for suicidal ideation and suicide attempt among young people.

DESIGN: A cross-sectional study.

SETTING: Data were collected from an online survey in Wuhan, China.

PARTICIPANTS: 5988 university students from six universities were selected by a stratified cluster sampling method.

PRIMARY AND SECONDARY OUTCOME MEASURES: Suicidal ideation and suicide attempt at some point of the students' lifetime were the outcomes of interest.

RESULTS: Students with suicidal ideation or attempted suicide reported a lower level of life satisfaction and high degree of psychache than counterparts without suicidal ideation or attempt. Regression analyses indicated that life satisfaction and psychache were significantly associated with the risk of suicidal ideation and the risk of suicidal attempt. Though psychache showed a relatively stronger predictive power than life satisfaction, the effect of the two factors remained significant when they were individually adjusted for personal demographic characteristics. However, when the two factors were included in the model simultaneously to adjust for each other, psychache could fully explain the association between life satisfaction and suicidal attempt. Life satisfaction remained to contribute unique variance in the statistical prediction of suicidal ideation.

CONCLUSIONS: Psychache and life satisfaction both have a significant predictive power on risk for suicidal behaviour, and life satisfaction could relieve the predictive power of psychache when suicidal behaviour is just starting. Shneidman's theory that psychache is the pre-eminent psychological cause of suicide is perhaps applicable only to a more serious form of suicidal behaviour.