title: A naturalistic study of suicidal adolescents treated with an SSRI: suicidal ideation and behavior during 3-month post-hospitalization period.
abstract: OBJECTIVE
  Describe suicidal ideation and suicide related/other emergencies (SRE), among depressed and acutely suicidal adolescents during a 3-month period following psychiatric hospitalization.
  
  
  METHODS
  One hundred twenty adolescents, who were both depressed and suicidal, were receiving an SSRI either alone or in combination with other medications, remained on a consistent medication regimen between baseline and at 3-months and their 3-month outcome data were available. The participants were divided into four medication groups: SSRI antidepressant only (n=71); SSRI plus mood stabilizer (n=17); SSRI plus antipsychotic (n=20); and SSRI plus antipsychotic and mood stabilizer (n=12). Standardized instruments were used.
  
  
  RESULTS
  Mean age=15.5±1.3, Caucasian=80.8%, female=74.2%, mean CDRS-R=61.7±12.1, suicide attempt during month prior to hospitalization=58.6%. During the 3-month post-hospitalization period: (1) there were no suicides, six participants (5%) attempted suicide and 21 (17.5%) experienced an SRE; (2) decline in suicidal ideation and depression severity was noted; (3) SSRI plus an antipsychotic group reported the highest number of SREs; (4) higher baseline hopelessness and aggression scores were associated with greater reduction in suicidal ideation at 3-months.
  
  
  CONCLUSIONS
  Declines in suicidal ideation, depression severity, and suicide attempts were noted, irrespective of psychotropic-combination received. A higher rate of SREs was associated with receiving an antipsychotic agent in combination with an SSRI. Given naturalistic design of study, cause-effect conclusions cannot be drawn. The lack of an objective measure to identify medication adherence is a study limitation.
authors.affiliation: University of Michigan, Ann Arbor, United States. Electronic address: neerag@med.umich.edu.
authors.forename: Neera
authors.initials: N
authors.lastname: Ghaziuddin
authors.affiliation: Northeastern Illinois University, Chicago, United States. Electronic address: C-Merchant@neiu.edu.
authors.forename: Christopher
authors.initials: C
authors.lastname: Merchant
authors.affiliation: University of Michigan, Ann Arbor, United States. Electronic address: dopp@med.umich.edu.
authors.forename: Richard
authors.initials: R
authors.lastname: Dopp
authors.affiliation: University of Michigan, Ann Arbor, United States. Electronic address: kingca@umich.edu.
authors.forename: Cheryl
authors.initials: C
authors.lastname: King
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Adolescents; SSRI; Suicide