title: Psychotic boys performing well in school are at increased risk of suicidal ideation.
abstract: OBJECTIVE
  This study investigated how the level of school performance is associated with suicidal behavior and psychiatric disorders among adolescent psychiatric inpatients aged 12-17 years.
  
  
  METHODS
  Data were collected from 508 adolescents (300 girls, 208 boys; age 12-17 years) admitted to inpatient psychiatric hospitalization between April 2001 and March 2006. Information on the adolescents' school performance, suicidal ideation, suicide attempts and self-mutilation as well as psychiatric DSM-IV diagnoses was obtained using the Schedule for Affective Disorder and Schizophrenia for School-Age Children.
  
  
  RESULTS
  An elevated risk of suicidal ideation (OR = 3.6, 95% CI 1.3-10.2, P = 0.017) and of psychotic disorders (OR = 3.2, 95% CI 1.0-10.0, P = 0.048) was observed among male adolescents performing well in school. In addition, adolescents with poor school performance had an increased likelihood of substance-related disorder both in boys (OR = 2.6, 95% CI 1.1-6.1, P = 0.027) and girls (OR = 2.5, 95% CI 1.2-5.1, P = 0.011).
  
  
  CONCLUSIONS
  Our findings indicate that psychotic inpatient male adolescents performing well in school are at an elevated risk of suicidal ideation. Although good school performance is often considered a marker of high intelligence and good general ability, symptoms of major psychiatric disorders and suicidality need to be taken very seriously among adolescents performing well in school.
authors.affiliation: Department of Psychiatry, University of Oulu, Oulu, Finland.
authors.forename: Vesa
authors.initials: V
authors.lastname: Tikkanen
authors.forename: Antti
authors.initials: A
authors.lastname: Alaräisänen
authors.forename: Helinä
authors.initials: H
authors.lastname: Hakko
authors.forename: Pirkko
authors.initials: P
authors.lastname: Räsänen
authors.forename: Kaisa
authors.initials: K
authors.lastname: Riala
mesh_terms: D000293:Adolescent; D002648:Child; D004522:Educational Status; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D012574:Schools; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data