title: Suicide-related events among child and adolescent patients during short-term antidepressant therapy.
abstract: OBJECTIVE
  Antidepressants have been of limited use for adolescent subjects with depression because of drug-induced suicide-related events (SRE). Therefore, we investigated actual suicidality and its risk factors during antidepressant therapy among child and adolescent patients in clinical settings.
  
  
  METHODS
  The risks of SRE, consisting of suicidal ideation, self-mutilation and suicide attempt, were prospectively monitored among 70 child and adolescent patients (15.4 ± 2.8 years) during the first 3 months of antidepressant therapy.
  
  
  RESULTS
  The proportion of SRE decreased from 47.1% to 22.9% after the treatment. Subjects with persistent risks of SRE were significantly characterized by female sex (P < 0.05), psychotic features (P < 0.001), borderline personality disorder (P < 0.01), previous SRE (P < 0.001), and such baseline psychopathology as anhedonia (P < 0.005), irritability (P < 0.005) and hopelessness (P < 0.001). Discriminant analysis showed that baseline severity of SRE, borderline personality disorder and psychotic features were closely associated with SRE during antidepressant therapy. Total scoring using those three pretreatment factors predicted risks of SRE with sufficient sensitivity (81%)/specificity (98%) as well as high positive likelihood ratio (43.9).
  
  
  CONCLUSIONS
  These findings suggest that deteriorated risk of SRE in child and adolescent patients receiving antidepressants should not be overestimated while some pretreatment characteristics may be useful to predict the outcome of SRE after antidepressant therapy.
authors.affiliation: Department of Neuropsychiatry, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan. kuba.teizo@gmail.com
authors.forename: Teizo
authors.initials: T
authors.lastname: Kuba
authors.forename: Takashi
authors.initials: T
authors.lastname: Yakushi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukuhara
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Nakamoto
authors.forename: Singeru Travis
authors.initials: ST
authors.lastname: Singeo
authors.forename: Osamu
authors.initials: O
authors.lastname: Tanaka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D012307:Risk Factors; D012652:Self Mutilation / Q000139:chemically induced* / Q000150:complications; D012720:Severity of Illness Index; D012727:Sex Characteristics; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents