Suicide attempts among depressed adolescents in primary care.
Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters showed elevated levels of psychopathology, specifically depressive symptoms, externalizing behaviors, anxiety, substance use, mania, and posttraumatic stress disorder symptoms. Externalizing behaviors and depression severity uniquely contributed to the prediction of suicide attempts in multivariate analyses. High levels of environmental stress as well as a few key stressful events were associated with suicide attempts; a recent romantic breakup or being assaulted added to suicide attempt risk, beyond the effects of psychopathology. Implications of results for primary care preventive services and suicide attempt prevention are discussed.
Department of Psychology, University of California at Los Angeles, Los Angeles, CA 90024-1759, USA.
Samantha R
SR
Fordwood
Joan R
JR
Asarnow
Diana P
DP
Huizar
Steven P
SP
Reise
D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008016:Life Change Events; D008297:Male; D008329:Managed Care Programs; D010552:Personality Assessment; D011320:Primary Health Care; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000534:rehabilitation; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*
D000928:Antidepressive Agents