title: Cognitive and family correlates of current suicidal ideation in children with bipolar disorder.
abstract: BACKGROUND
  Suicidality among youth with bipolar disorder is an extreme, but largely unaddressed, public health problem. The current study examined the psychosocial characteristics differentiating youth with varying severities of suicidal ideation that may dictate targets for suicide prevention interventions.
  
  
  METHODS
  Participants included 72 youth aged 7-13 (M=9.19, SD=1.61) with DSM-IV-TR bipolar I, II, or NOS and a parent/caregiver. Current suicidal ideation and correlates were assessed at intake, including: demographics and clinical factors (diagnosis, symptom severity, psychiatric comorbidity); child factors (cognitive risk and quality of life); and family factors (parenting stress, family cohesion, and family rigidity).
  
  
  RESULTS
  Current ideation was prevalent in this young sample: 41% endorsed any ideation, and 31% endorsed active forms. Depression symptoms, quality of life, hopelessness, self-esteem, and family rigidity differentiated youth with increasing ideation severity. Separate logistic regressions examined all significant child- and family-level factors, controlling for demographic and clinical variables. Greater family rigidity and lower self-esteem remained significant predictors of current planful ideation. Diagnosis, index episode, comorbidity, and mania severity did not differentiate non-ideators from those with current ideation.
  
  
  CONCLUSIONS
  Limitations include the small sample to examine low base-rate severe ideation, cross-sectional analyses and generalizability of findings beyond the outpatient clinical sample.
  
  
  CONCLUSIONS
  Findings underscore the importance of assessing and addressing suicidality in preadolescent youth with bipolar disorder, before youth progress to more severe suicidal behaviors. Results also highlight child self-esteem and family rigidity as key treatment targets to reduce suicide risk in pediatric bipolar disorder.
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA. Electronic address: sweinstein@psych.uic.edu.
authors.forename: Sally M
authors.initials: SM
authors.lastname: Weinstein
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA; Yeshiva University, New York, NY, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Van Meter
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Katz
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Amy T
authors.initials: AT
authors.lastname: Peters
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: West
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology*; D002641:Chicago / Q000453:epidemiology; D002648:Child; D003071:Cognition; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012649:Self Concept; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*
keywords: Cognitive vulnerability; Family environment; Pediatric bipolar disorder; Suicidal ideation