Predictors of Suicidal Behaviors during Hospitalization among Adolescents Admitted Due to Suicidal Behaviors: A 10-Year Retrospective Naturalistic Study

Abstract

Objectives: Suicidality during hospitalization is a common phenomenon with potential devastating consequences. We attempted to identify risk factors for in-hospital suicidality in a high risk group of adolescent inpatients hospitalized for suicidal behaviors (SB). Methods: The database of a tertiary adolescent psychiatric ward was screened for patients hospitalized consecutively for SB during 2001–2010. Data on documented demographic, clinical, and behavioral risk factors were collected. Suicidal events during hospitalization were classified according to the Columbia Classification Algorithm of Suicide Assessment. Results: The sample included 122 inpatients (53% female) aged 10–19 (Mean=15.77, Standard Deviation=2.89) years admitted for SB. Thirty-seven youth (30%) exhibited SB during the hospitalization period (the “suicidal group”), ten of which attempted suicide while hospitalized. There were no significant differences in demographic and clinical parameters between the suicidal and the non-suicidal groups. Younger age, history of drug use and a history of non-suicidal self-injury (NSSI) were independent predictors of a SA during hospitalization. A previous SA added significant risk to SA during hospitalization only in the group that had a history of NSSI. Conclusions: A high risk of SB exists among adolescents hospitalized for suicidality. The risk assessment for SA during hospitalization should include age, history of drug use and previous SA combined with a history of NSSI. Future studies should expand the efforts to identify potential risk factors of SB during hospitalization in this unique high-risk group.

Keywords:

• suicidal behaviors
• adolescents
• suicide attempts
• non-suicidal self-injury
• suicidal ideation

Additional information

Notes on contributors

Maya Amitai

Maya Amitai, Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychological Medicine, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel.

Reut Ben Baruch

Reut Ben Baruch, Geha Mental Health Center, Petach Tikva, Israel.

David H Ben-Dor

David H. Ben-Dor, Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Dorit Ben-Ami

Dorit Ben-Ami, Geha Mental Health Center, Petach Tikva, Israel.

Michael Katz

Michael Katz, Geha Mental Health Center, Petach Tikva, Israel; Derner School of Psychology, Adelphi University, Garden City, NY, USA.

Roi Sagy

Roi Sagy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Brill Mental Health Center, Tal-Aviv, Israel.

Roei Remez

Roei Remez, Geha Mental Health Center, Petach Tikva, Israel.

Noam Liav

Noam Liav, Geha Mental Health Center, Petach Tikva, Israel.

Moran Leibovich

Moran Leibovich, Geha Mental Health Center, Petach Tikva, Israel.

Alan Apter

Alan Apter, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychological Medicine, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel.

Abraham Weizman

Abraham Weizman, Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Felsenstein Medical Research Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Gil Zalsman

Gil Zalsman, Geha Mental Health Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Felsenstein Medical Research Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry Divisions of Molecular Imaging and Neuropathology, Columbia University, New York, NY, USA.