title: Demographic and clinical correlates of suicidality in adolescents attending a specialist community mental health service: a naturalistic study.
abstract: BACKGROUND
  Adolescents comprise a unique and often challenging group of patients with diverse presentations to the Mental Health Services; suicidal behavior being one of them.
  
  
  OBJECTIVE
  The main aim of this naturalistic project was to investigate demographic and clinical correlates of adolescent suicidal and self-harm events, which may be of value to decision-making in clinical practice.
  
  
  METHODS
  All adolescents (n = 149) registered and actively managed by a specialist community mental health service in South London were included in the study. Clinical information from their files was used to determine suicidality/self-harm events. The Columbia Classification Algorithm of Suicide Assessment (C-CASA) was utilised for classification purposes. Logistic regression was used to explore the effects of age, sex, diagnosis, medication, substance use (alcohol and/or cannabis) and ethnicity on suicidality/self-harming behaviors.
  
  
  RESULTS
  Age, sex and use of psychotropic medication were identified to play a significant role in determining the risk of engaging in self-harming behavior. The risk was higher with increasing age and female sex. Medication seemed to have a protective effect. Reporting a 20% prevalence of non-suicidal self-injury (NSSI) in our population, we highlight the importance of NSSI as a distinct diagnostic category.
  
  
  CONCLUSIONS
  Our findings have implications for risk assessment and appropriate decision-making in clinical settings. Results are translatable and relevant to other metropolitan areas.
authors.affiliation: a Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA .|b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK .
authors.forename: Sotirios
authors.initials: S
authors.lastname: Posporelis
authors.affiliation: b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK .
authors.forename: Aspasia
authors.initials: A
authors.lastname: Paspali
authors.affiliation: c Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA .
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Takayanagi
authors.affiliation: a Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA .
authors.forename: Akira
authors.initials: A
authors.lastname: Sawa
authors.affiliation: b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK .
authors.forename: Partha
authors.initials: P
authors.lastname: Banerjea
authors.affiliation: b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK .|d Institute of Psychiatry, Psychology and Neuroscience King's College London , London , UK , and.|e Department of Psychiatry , Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Marinos
authors.initials: M
authors.lastname: Kyriakopoulos
mesh_terms: D000293:Adolescent; D000367:Age Factors; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D012737:Sex Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Suicidality; adolescents; community mental health