title: Self-Reported Recent Life Stressors and Risk of Suicide in Pediatric Emergency Department Patients.
abstract: Emergency departments (EDs) are important venues for detecting youth at risk for suicide. Children and adolescents who present to the ED and report a recent life stressor, such as stressors related to interpersonal relationships, may be at elevated risk for suicide. Utilizing data from three large, urban pediatric EDs, we examined the relationship between reported recent life stressors and suicide risk, as measured by the Suicidal Ideation Questionnaire. Overall, youth who reported a recent life stressor were at elevated risk of suicide [adjOR = 5.43 (95% CI, 3.18-9.26)]. Importantly, however, this finding was tempered by the fact that 20% of youth who screened positive for suicide risk did not report a stressor. Thus, while the knowledge of stressors may provide useful supplementary information to a suicide risk assessment, the presence or absence of a reported stressor is not sufficient to determine one's risk of suicide. ED clinicians are advised to include direct questions about suicidal thoughts and behaviors.
authors.affiliation: Office of the Clinical Director National Institute of Mental Health, NIH stanleyih@mail.nih.gov W: 301-451-2114.
authors.forename: Ian H
authors.initials: IH
authors.lastname: Stanley
authors.forename: Deborah
authors.initials: D
authors.lastname: Snyder
authors.forename: Sarah
authors.initials: S
authors.lastname: Westen
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Ballard
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Teach
authors.forename: Suad
authors.initials: S
authors.lastname: Kapetanovic
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Wharff
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bridge
authors.forename: Katherine
authors.initials: K
authors.lastname: Ginnis
authors.forename: Maryland
authors.initials: M
authors.lastname: Pao
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Horowitz
keywords: emergency department; recent life stressor; suicide risk; youth
references.citation: Br J Psychiatry. 2003 Jul;183:28-33
references.pmid: 12835240
references.citation: Pediatrics. 2001 May;107(5):1133-7
references.pmid: 11331698
references.citation: Can J Psychiatry. 1994 Feb;39(1):43-8
references.pmid: 8193997
references.citation: J Am Acad Child Adolesc Psychiatry. 1999 Dec;38(12):1497-505
references.pmid: 10596249
references.citation: Acad Emerg Med. 2009 Nov;16(11):1234-41
references.pmid: 19845554
references.citation: Arch Pediatr Adolesc Med. 2012 Dec;166(12):1170-6
references.pmid: 23027429
references.citation: Pediatrics. 2011 May;127(5):e1356-66
references.pmid: 21518712
references.citation: Curr Opin Pediatr. 2009 Oct;21(5):620-7
references.pmid: 19617829
references.citation: Am J Psychiatry. 2003 Jun;160(6):1093-9
references.pmid: 12777267
references.citation: Int J Adolesc Med Health. 2002 Jan-Mar;14(1):55-60
references.pmid: 12467207
references.citation: Pediatr Emerg Care. 2010 Nov;26(11):787-92
references.pmid: 20944511
references.citation: Curr Opin Pediatr. 2007 Aug;19(4):398-404
references.pmid: 17630602
references.citation: J Child Psychol Psychiatry. 2006 Mar-Apr;47(3-4):372-94
references.pmid: 16492264