Psychotic boys performing well in school are at increased risk of suicidal ideation.
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.
Tikkanen
Vesa
V
Department of Psychiatry, University of Oulu, Oulu, Finland.
Alaräisänen
Antti
A
Hakko
Helinä
H
Räsänen
Pirkko
P
Riala
Kaisa
K
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