Suicidal Thoughts and Behaviors Among Adolescent Psychiatric Inpatients

Abstract

Background

Given low base rates of suicidal thoughts and behaviors (STBs) in national samples of adolescents, clarifying the sociodemographic and clinical correlates among psychiatric inpatients may afford insights into potential risk factors that predict STBs onset.

Method

Adolescents (N = 970; ages 12–19 years) admitted for acute, psychiatric inpatient care completed baseline clinical interviews and self-report measures assessing demographics and early life adversity. Lifetime and 12-month STBs prevalence were obtained, allowing for the estimate of STBs persistence (i.e., rates of those with both current and past STBs) and transition rates (i.e., proportion of ideators that transition to plans or attempts). Univariate and multivariate logistic regression tested sociodemographic and clinical correlates of STBs.

Results

Age-of-onset for STBs occurred in early adolescence. Most patients reported suicide ideation with nearly half of patients making a plan and one-third a suicide attempt. Although relatively modest, the strongest correlates of lifetime attempts were depressive disorders, physical abuse, and non-suicidal self-injury. Knowing a peer that had attempted suicide also increased the likelihood of a suicide attempt, especially among attempters who transitioned from ideation to planned attempts.

Conclusion

STBs are highly prevalent among adolescents admitted for acute psychiatric inpatient treatment. The modest effects suggest that correlates, particularly those related to suicide attempts, are widely distributed. As a history of physical abuse and knowing a peer with a suicide attempt history are related to transitioning from ideation to action, these may be critical factors to target in the deployment of future suicide prevention and treatment programs.

HIGHLIGHTS

• One-third of adolescent inpatients report a lifetime history of suicide attempts.

• Approximately 65% of adolescent inpatients with a lifetime plan attempt suicide.

• Knowing peers who attempt suicide may facilitate the transition from ideation to action.

Keywords:

• Comorbidity
• contagion
• non-suicidal self-injury
• physical abuse
• suicide

DISCLOSURE STATEMENT

Dr. Auerbach is an unpaid scientific advisor for Ksana Health. All other authors report no biomedical financial interests or potential conflicts of interest.

AUTHORS NOTES

Kira L. Alqueza, David Pagliaccio, Katherine Durham, Apoorva Srinivasan, Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.

Jeremy G. Stewart, Department of Psychology and Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada.

Randy P. Auerbach, Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.

Additional information

Funding

This project was supported by the National Institute of Mental Health [U01MH116923], Tommy Fuss Fund, and Simches Fund awarded to RPA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or of any other sponsor.