title: First-time suicide attempters, repeat attempters, and previous attempters on an adolescent inpatient psychiatry unit.
abstract: OBJECTIVE
  To compare clinical characteristics of hospitalized adolescents who (1) have recently made their first suicide attempt, (2) have recently made a second or subsequent attempt, (3) have made previous but no recent attempts, or (4) have never made an attempt.
  
  
  METHODS
  Semistructured psychiatric diagnostic interviews were used to determine history of recent and previous suicidal behavior among 225 consecutively admitted adolescents to an inpatient psychiatric facility. Twenty-seven first-time attempters, 32 repeat attempters, and 40 previously suicidal youths were compared with 126 nonsuicidal youths in terms of severity of self-reported depressive symptoms, state anxiety, trait anxiety, state anger, and trait anger.
  
  
  RESULTS
  Repeat attempters and previous attempters both reported more depressive symptomatology and trait anxiety than did nonsuicidal youths. In addition, youths with a previous history of suicide attempts, but no recent attempts, evidenced more trait anger than all other groups. First-time suicide attempters reported levels of distress that were intermediate to the other groups.
  
  
  CONCLUSIONS
  Repeat attempters and previous attempters in hospital settings both report more distress than do nonsuicidal youths. Interventions should focus not only on resolution of immediate crises, but also on youths' ability to cope with ongoing difficulties that engender depression and chronic anxiety.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC 27157-1087, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Goldston
authors.forename: S
authors.initials: S
authors.lastname: Daniel
authors.forename: D M
authors.initials: DM
authors.lastname: Reboussin
authors.forename: A
authors.initials: A
authors.lastname: Kelley
authors.forename: C
authors.initials: C
authors.lastname: Ievers
authors.forename: R
authors.initials: R
authors.lastname: Brunstetter
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003419:Crisis Intervention; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission; D010552:Personality Assessment; D012008:Recurrence; D012307:Risk Factors; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*