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European Child & Adolescent Psychiatry
Published in: European Child & Adolescent Psychiatry 4/2006

01-06-2006 | ORIGINAL CONTRIBUTION

Suicidal ideation, deliberate self-harm behaviour and suicide attempts among adolescent outpatients with depressive mood disorders and comorbid axis I disorders

Authors: Virpi Tuisku, MSocSc, Mirjami Pelkonen, PhD, Linnea Karlsson, MD, PhD, Olli Kiviruusu, MSocSc, Matti Holi, MD, PhD, Titta Ruuttu, MA, Raija-Leena Punamäki, PhD, Mauri Marttunen, MD, PhD

Published in: European Child & Adolescent Psychiatry | Issue 4/2006

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Abstract

Objective

We aimed to analyse and compare prevalence and associated clinical features of suicidal ideation, self-harm behaviour with no suicidal intent and suicide attempts among adolescent outpatients with depressive mood disorders with or without comorbidity.

Method

A sample of 218 consecutive adolescent outpatients aged 13–19 years with depressive mood disorders was interviewed using K-SADS-PL for DSM-IV Axis I diagnoses. They filled out self-report questionnaires assessing depressive and anxiety symptoms. Suicidal behaviour was assessed by K-SADS-PL suicidality items.

Results

Half of the subjects reported suicidal ideation or behaviour. There was no difference in prevalence of suicidal behaviour between non-comorbid and comorbid mood disorder groups. Multivariate logistic regression analyses produced the following associations: (1) suicidal ideation with self-reported depressive symptoms and poor psychosocial functioning, (2) deliberate self-harm behaviour with younger age and poor psychosocial functioning, and (3) suicide attempts with self-reported depressive symptoms and poor psychosocial functioning.

Conclusions

Depressed mood disorders, whether comorbid or not, are associated with suicidal ideation and suicide attempts. Diagnostic assessment should be supplemented by self-report methods when assessing suicidal behaviour in depressed adolescents.
Literature
1.
Aalto-Setälä T, Marttunen M, Tuulio-Henriksson A, Poikolainen K, Lönnqvist J (2002) Psychiatric treatment seeking and psychosocial impairment among young adults with depression. J Affect Disord 70:35–47PubMedCrossRef
2.
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV. American Psychiatric Association, Washington DC
3.
4.
Beautrais AL (2003) Suicide and serious suicide attempts in youth: a multiple-group comparison study. Am J Psychiatry 160:1093–1099PubMedCrossRef
5.
Beautrais AL, Joyce PR, Mulder RT (1998) Psychiatric illness in a New Zealand sample of young people making serious suicide attempts. NZ Med J 111:44–48
6.
Beautrais AL, Joyce PR, Mulder RT (1996) Risk factors for serious suicide attempts among youths aged 13 through 24 years. J Am Acad Child Adolesc Psychiatry 35:1174–1182PubMedCrossRef
7.
Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897PubMedCrossRef
8.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed
9.
Briere J, Gil E (1998) Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. Am J Orthopsychiatry 68:609–620PubMed
10.
Brooks SJ, Kutcher S (2001) Diagnosis and measurement of adolescent depression: a review of commonly utilized instruments. J Child Adolesc Psychopharmacol 11:341–376PubMedCrossRef
11.
Darche M (1990) Psychological Factors differentiating self-mutilating and non-self-mutilating adolescent inpatients females. Psychiatr Hospital 21:31–35
12.
Esposito CL, Clum GA (2002) Psychiatric symptoms and their relationship to suicidal ideation in a high-risk adolescent community sample. J Am Acad Child Adolesc Psychiatry 41:44–51PubMedCrossRef
13.
Esposito CL, Clum GA (2003) The relative contribution of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. J Clin Child Adolesc Psychol 32:386–395PubMedCrossRef
14.
Feehan M, McGee R, Williams SM (1993) Mental health disorders from age 15 to age 18 years. J Am Acad Child Adolesc Psychiatry 32:1118–1126PubMed
15.
Fergusson DM, Lynskey MT (1995) Suicide attempts and suicidal ideation in a birth cohort of 16-year-old New Zealanders. J Am Acad Child Adolesc Psychiatry 34:1308–1317PubMedCrossRef
16.
Fleiss J, Cohen J (1973) The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educ Psychol Meas 33:6113–6619
17.
Ghaziuddin N, King CA, Naylor MW, Ghaziuddin M (2000) Anxiety contributes to suicidality in depressed adolescents. Depress Anxiety 11:134–138PubMedCrossRef
18.
Goldberg D (1972) The detection of minor psychiatric illness by questionnaire. Oxford University Press, Oxford
19.
Goldston DB, Daniel SS, Reboussin BA, Reboussin DM, Kelley AE, Frazier PH (1998) Psychiatric diagnoses of previous suicide attempters, first-time attempters, and repeat attempters on an adolescent inpatient psychiatry unit. J Am Acad Child Adolesc Psychiatry 37:924–932PubMedCrossRef
20.
Gould S, King R, Greenwald S, Fisher P, Schwab-Stone M, Kramer R, Flisher A, Goodman S, Canino G, Schaffer D (1998) Psychopathology associated with suicidal ideation and attempts among children and adolescents. J Am Acad Child Adolesc Psychiatry 37:915–923PubMedCrossRef
21.
Groholt B, Ekeberg O, Haldorsen T (2000) Adolescents hospitalised with deliberate self-harm: the significance of an intention to die. Eur Child Adolesc Psychiatry 9:244–254PubMedCrossRef
22.
Guertin T, Lloyd-Richardson E, Spirito A, Donaldson D, Boergers J (2001) Self-mutilative behavior in adolescents who attempt suicide by overdose. J Am Acad Child Adolesc Psychiatry 40:1062–1069PubMedCrossRef
23.
Gurley D, Cohen P, Pine DS, Brook J (1996) Discriminating depression and anxiety in youth: a role for diagnostic criteria. J Affect Disord 39:191–200PubMedCrossRef
24.
Hamilton J, Gillham J (1999) The K-SADS and diagnosis of major depressive disorder. J Am Acad Child Adolesc Psychiatry 38:1065–1069PubMedCrossRef
25.
Hawton K, Houston K, Haw C, Townsend E, Harriss L (2003) Comorbidity of axis I and axis II disorders in patients who attempted suicide. Am J Psychiatry 160:1494–1500PubMedCrossRef
26.
Hawton K, Rodham K, Evans E, Weatherall R (2002) Deliberate self harm in adolescents: self report survey in schools in England. BMJ 325:1207–1211PubMedCrossRef
27.
Kaufman J, Birmaher B, Brent DA, Rao U, Flynn C, Moreci P, Williamson DE, Ryan ND (1997) Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–987PubMedCrossRef
28.
Kessler RC, Avenevoli S, Ries Merikangas K (2001) Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 49:1002–1014PubMedCrossRef
29.
Klonsky ED, Oltmanns TF, Turkheimer E (2003) Deliberate self-harm in a nonclinical population: prevalence and psychological correlates. Am J Psychiatry 160:1501–1508PubMedCrossRef
30.
Kosky R, Silburn S, Zubrick SR (1990) Are children and adolescents who have suicidal thoughts different from those who attempt suicide? J Nerv Mental Dis 178:38–43
31.
Kovacs M, Gatsonis C, Paulauskas SL, Richards C (1989) Depressive disorders in childhood. IV. A longitudinal study of comorbidity with and risk for anxiety disorders. Arch Gen Psychiatry 46:776–782PubMed
32.
Kovacs M, Goldston D, Gatsonis C (1993) Suicidal behaviors and childhood-onset depressive disorders: a longitudinal investigation. J Am Acad Child Adolesc Psychiatry 32:8–20PubMed
33.
Lewinsohn PM, Rohde P, Seeley JR (1995) Adolescent psychopathology: III. The clinical consequences of comorbidity. J Am Acad Child Adolesc Psychiatry 34:510–519PubMedCrossRef
34.
Lewinsohn PM, Rohde P, Seeley JR (1996) Adolescent suicidal ideation and attempts: prevalence, risk factors, and clinical implications. Clin Psychol Sci Pract 3:25–46CrossRef
35.
Lewinsohn PM, Zinbarg R, Seeley JR, Lewinsohn M, Sack WH (1997) Lifetime comorbidity among anxiety disorders and between anxiety disorders and other mental disorders in adolescents. J Anxiety Disord 11:377–394PubMedCrossRef
36.
Martin G, Rozanes P, Pearce C, Allison S (1995) Adolescent suicide, depression and family dysfunction. Acta Psychiatr Scand 92:336–344PubMed
37.
Muehlenkamp JJ, Gutierrez PM (2004) An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide Life Threat Behav 34:12–23PubMedCrossRef
38.
Myers K, Winters NC (2002) Ten-year review of rating scales. II: Scales for internalizing disorders. J Am Acad Child Adolesc Psychiatry 41:634–659PubMedCrossRef
39.
Pelkonen M, Marttunen M, Laippala P, Lonnqvist J (2000) Factors associated with early dropout from adolescent psychiatric outpatient treatment. J Am Acad Child Adolesc Psychiatry 39:329–336PubMedCrossRef
40.
Pelkonen M, Marttunen M, Pulkkinen E, Laippala P, Aro H (1997) Characteristics of out-patient adolescents with suicidal tendencies. Acta Psychiatr Scand 95:100–107PubMed
41.
Rohde P, Lewinsohn PM, Seeley JR (1991) Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults. J Abnormal Psychol 100:214–222CrossRef
42.
Ross S, Heath N (2002) A study of the frequency of self-mutilation in a community sample of adolescents. J Youth Adolesc 31:67–77CrossRef
43.
Sanford M, Szatmari P, Spinner M, Munroe-Blum H, Jamieson E, Walsh C, Jones D (1995) Predicting the one-year course of adolescent major depression. J Am Acad Child Adolesc Psychiatry 34:1618–1628PubMedCrossRef
44.
SAS Institute Inc. (1999) SAS Online Doc, Version 8. SAS Institute Inc, Cary, NC
45.
Shanee N, Apter A, Weizman A (1997) Psychometric properties of the K-SADS-PL in an Israeli adolescent clinical population. Isr J Psychiatry Relat Sci 34:179–186PubMed
46.
SPSS Inc. (2001) SPSS Base 11.0 for Windows User’s Guide. SPSS Inc., Chigaco, IL
47.
Strauss J, Birmaher B, Bridge J, Axelson D, Chiappetta L, Brent D, Ryan N (2000) Anxiety disorders in suicidal youth. Can J Psychiatry (Revue Canadienne de Psychiatrie) 45:739–745
48.
Suymoto K (1998) The functions of self-mutilation. Clin Psychol Rev 18:531–554CrossRef
49.
Wetzler S, Asnis GM, Hyman RB, Virtue C, Zimmerman J, Rathus JH (1996) Characteristics of suicidality among adolescents. Suicide Life Threat Behav 26:37–45PubMed
50.
Wunderlich U, Bronisch T, Wittchen HU (1998) Comorbidity patterns in adolescents and young adults with suicide attempts. Eur Arch Psychiatry Clin Neurosci 248:87–95PubMedCrossRef
51.
Zlotnick C, Donaldson D, Spirito A, Pearlstein T (1997) Affect regulation and suicide attempts in adolescent inpatients. J Am Acad Child Adolesc Psychiatry 36:793–798PubMedCrossRef
Metadata
Title
Suicidal ideation, deliberate self-harm behaviour and suicide attempts among adolescent outpatients with depressive mood disorders and comorbid axis I disorders
Authors
Virpi Tuisku, MSocSc
Mirjami Pelkonen, PhD
Linnea Karlsson, MD, PhD
Olli Kiviruusu, MSocSc
Matti Holi, MD, PhD
Titta Ruuttu, MA
Raija-Leena Punamäki, PhD
Mauri Marttunen, MD, PhD
Publication date
01-06-2006
Publisher
Steinkopff-Verlag
Published in
European Child & Adolescent Psychiatry / Issue 4/2006
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-005-0522-3

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