title: The Treatment of Adolescent Suicide Attempters study (TASA): predictors of suicidal events in an open treatment trial.
abstract: OBJECTIVE
  To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial.
  
  
  METHODS
  Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral).
  
  
  RESULTS
  The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event.
  
  
  CONCLUSIONS
  In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted.
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University. Electronic address: brentda@upmc.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Laurence L
authors.initials: LL
authors.lastname: Greenhill
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Scott
authors.initials: S
authors.lastname: Compton
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Graham
authors.initials: G
authors.lastname: Emslie
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Karen
authors.initials: K
authors.lastname: Wells
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: John T
authors.initials: JT
authors.lastname: Walkup
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Vitiello
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Oscar
authors.initials: O
authors.lastname: Bukstein
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Barbara
authors.initials: B
authors.lastname: Stanley
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Kelly
authors.initials: K
authors.lastname: Posner
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Betsy D
authors.initials: BD
authors.lastname: Kennard
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Cwik
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Ann
authors.initials: A
authors.lastname: Wagner
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Barbara
authors.initials: B
authors.lastname: Coffey
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: John S
authors.initials: JS
authors.lastname: March
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Mark
authors.initials: M
authors.lastname: Riddle
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Tina
authors.initials: T
authors.lastname: Goldstein
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: John
authors.initials: J
authors.lastname: Curry
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Shannon
authors.initials: S
authors.lastname: Barnett
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Lisa
authors.initials: L
authors.lastname: Capasso
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Jamie
authors.initials: J
authors.lastname: Zelazny
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: Sa
authors.initials: S
authors.lastname: Shen
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: S Sonia
authors.initials: SS
authors.lastname: Gugga
authors.affiliation: Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.
authors.forename: J Blake
authors.initials: JB
authors.lastname: Turner
mesh_terms: D000293:Adolescent; D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010555:Personality Inventory; D055502:Secondary Prevention; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D000928:Antidepressive Agents