title: Auditory verbal hallucinations increase the risk for suicide attempts in adolescents with suicidal ideation.
abstract: OBJECTIVE
  It is important to prevent patients with suicidal ideation from actually attempting suicide. A school based cohort study suggested that auditory verbal hallucinations (AVHs) might play an important role in driving young people with mental health problems to attempt suicide. However, no clinical study to date has specifically investigated the association between AVHs and suicide attempts among young patients with suicidal ideation.
  
  
  METHODS
  We conducted a cross-sectional study of first-visit psychiatric referrals aged 10-15years at two general child and adolescent mental health hospitals in Japan. We administered self-reported questionnaires to measure suicidal ideation and suicide attempts, AVHs, and depression in the two weeks prior to the date of first-visit.
  
  
  RESULTS
  Among 188 patients with suicidal ideation, the presence of AVHs was associated with increased odds of suicide attempts (OR 3.4, 95% CI 1.7-6.9; p<0.05); however, depression was not associated with a significant change of odds (OR 0.7, 95% CI 0.4-1.3; p=0.29).
  
  
  CONCLUSIONS
  AVHs may increase the risk of suicide attempts made by adolescents with suicidal ideation. Clinicians should consider AVHs when adolescent patients present with suicidal ideation.
authors.affiliation: Department of Child and Adolescent Psychiatry, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan; Department of Child Psychiatry, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. Electronic address: juniteef@gmail.com.
authors.forename: Junichi
authors.initials: J
authors.lastname: Fujita
authors.affiliation: Psychiatric Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa 232-0024, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nishida
authors.affiliation: Institute for Health Economics and Policy, No.11 Toyo-kaiji Bldg, 1-5-11 Nishi-Shinbashi, Minato-ku, Tokyo 105-0003 Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okumura
authors.affiliation: Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Ando
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Kawano
authors.affiliation: Department of Child and Adolescent Psychiatry, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Toyohara
authors.affiliation: Department of Child and Adolescent Psychiatry, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Sho
authors.affiliation: Department of Child and Adolescent Psychiatry, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Minami
authors.affiliation: Department of Child and Adolescent Psychiatry, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Arai
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006212:Hallucinations / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012306:Risk; D057566:Self Report; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
keywords: Auditory verbal hallucination; Child and adolescent mental health clinic; Depression; Early adolescents; Suicide attempt