title: Psychiatric disorders and attempted suicide among adolescents with substance use disorders.
abstract: OBJECTIVE
  To determine the effects of psychiatric disorders on attempted suicide among adolescents with substance use disorders (SUD).
  
  
  METHODS
  Age of onset for psychiatric disorders, age of first suicide attempt, and the relationship of psychiatric disorder with attempted suicide were investigated in a sample of 503 adolescents with DSM-IV defined SUD (age range: 12.2-19.0 years).
  
  
  RESULTS
  Males who attempted suicide had a significantly earlier onset of alcohol use disorders (AUD) and significantly more mood, AUD, and disruptive behavior disorder symptoms compared to non-attempting males. Females who attempted suicide had a significantly earlier onset and higher counts of mood disorders and SUD symptoms compared to non-attempting females. Hazard analysis revealed that mood disorders represent the highest psychiatric risk for attempted suicide in both the genders. Attention deficit-hyperactivity disorder (ADHD) increased the risk for attempted suicide among males. The interaction of mood disorder and AUD increased the risk for attempted suicide among females.
  
  
  CONCLUSIONS
  Clinicians should closely monitor SUD adolescents for suicide risk and be aware of gender differences for suicidal behavior based on course and severity of psychiatric disorder in this population.
authors.affiliation: Pittsburgh Adolescent Alcohol Research Center, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA. kellytm@msx.upmc.edu
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kelly
authors.forename: Jack R
authors.initials: JR
authors.lastname: Cornelius
authors.forename: Duncan B
authors.initials: DB
authors.lastname: Clark
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010414:Pennsylvania; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000706:statistics & numerical data; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*