Emergent suicidality in a clinical psychotherapy trial for adolescent depression.
OBJECTIVE
The authors' goal was to examine the incidence and predictors of emergent suicidality that occurred during a clinical trial of psychotherapy for adolescent depression.


METHODS
The rates and predictors of emergent suicidality in 88 medication-free depressed adolescent outpatients who reported no current suicidality during an intake interview were assessed over 12 to 16 weeks of psychotherapy treatment.


RESULTS
The incidence of emergent suicidality was 12.5% (11 of 88 subjects). Self-reported suicidal thoughts at intake were a significant predictor of emergent suicidality, even when suicidality was denied at intake interview.


CONCLUSIONS
Emergent suicidality is a common occurrence in psychosocial treatment of adolescent depression, with rates similar to those reported recently in antidepressant trials. To evaluate accurately the role of treatment in emergent suicidality, it is important to assess self-reported suicidality at intake and to balance treatment groups on this key predictor of emergent suicidality.
Bridge
Jeffrey A
JA
Western Psychiatric Institute & Clinic, Child and Adolescent Psychiatry, 3811 O'Hara St., BFT 311, Pittsburgh, PA 15213-2592, USA.
Barbe
Rémy P
RP
Birmaher
Boris
B
Kolko
David J
DJ
Brent
David A
DA
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000367:Age Factors; D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005196:Family Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009629:Person-Centered Psychotherapy; D010555:Personality Inventory / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000379:methods*; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D016896:Treatment Outcome