Format

Send to

Choose Destination
J Am Acad Child Adolesc Psychiatry. 2009 Oct;48(10):987-996. doi: 10.1097/CHI.0b013e3181b5dbe4.

The Treatment of Adolescent Suicide Attempters study (TASA): predictors of suicidal events in an open treatment trial.

Author information

1
Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University. Electronic address: brentda@upmc.edu.
2
Drs. Vitiello and Wagner are with the National Institute of Mental Health; Drs. Brent, Bukstein, and Goldstein and Ms. Zelazny are with the University of Pittsburgh, Western Psychiatric Institute & Clinic; Drs. Greenhill, Stanley, Posner, and Turner and Ms. Shen, Ms. Guggia, and Ms. Capasso are with the Columbia University-New York Psychiatric Institute; Drs. Emslie and Kennard and Ms. Hughes are with the University of Texas Southwestern Medical Center at Dallas; Drs. Wells, Compton, March, and Curry are with the Duke University Medical Center; Dr. Coffey is with the New York University Child Study Center; and Drs. Walkup, Cwik, and Riddle and Ms. Barnett are with Johns Hopkins University.

Abstract

OBJECTIVE:

To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial.

METHOD:

Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral).

RESULTS:

The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event.

CONCLUSIONS:

In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00080158.

PMID:
19730274
PMCID:
PMC2891930
DOI:
10.1097/CHI.0b013e3181b5dbe4
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Substance, Secondary source ID, Grant support

Publication types

MeSH terms

Substance

Secondary source ID

Grant support

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center