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Can J Psychiatry. 2015 Feb;60(2 Suppl 1):S27-36.

Risk and Protective Factors for Suicidality at 6-Month Follow-up in Adolescent Inpatients Who Attempted Suicide: An Exploratory Model.

Author information

1
Doctor, Service de Psychiatrie de l'Enfant et de l'Adolescent, Assistance Publique-Hopitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie, Paris, France; Doctor, Centre de Recherche, Institut du Cerveau et de la Moelle, Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie, Paris, France.
2
Professor and Head, Service de Psychiatrie de l'Enfant et de l'Adolescent, Assistance Publique-Hopitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie, Paris, France; Professor and Head, Centre National de Recherche Scientifique Unité Mixte de Recherche 7222 Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie Curie, Paris, France.
3
Biostatistician, Service de Psychiatrie de l'Enfant et de l'Adolescent, Assistance Publique-Hopitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie, Paris, France.
4
Professor and Department Head, Service de psychopathologie de l'enfant et de l'adolescent et Unité de médecine de l'adolescent, Centre hospitalier universitaire d'Amiens, Université Picardie Jules Verne, Amiens, France; Associate Professor, Départment de psychiatrie, Université de Monréal, Montréal, Québec; Assistant Professor, Division of Child Psychiatry, Department of Psychiatry, McGill University, Montréal, Québec; Researcher, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Hôpital Rivière-des-Prairies, Montréal, Québec.
5
Psychiatrist, Fédération hospitalo-universitaire de psychiatrie de l'enfant et de l'adolescent, Centre hospitalier universitaire de Rouen, Rouen, France ; PhD Student, Inserm U1079, Université de Rouen, Rouen, France.
6
Resident, Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalo-Universitaire d'Amiens et Université de Picardie, Amiens, France.
7
Doctor and Head, Département de Psychiatrie, Centre Hospitalier de Meaux, Meaux, France.
8
Associate Professor, Service de Psychiatrie de l'Enfant et de l'Adolescent, Assistance Publique-Hopitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie, Paris, France; Associate Professor, Centre de Recherche, Institut du Cerveau et de la Moelle, Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie, Paris, France.
9
Head, Section Jeunesse de la Clinique externe des troubles dépressifs et suicidaires, Institut universitaire en santé mentale Douglas, McGill University, Montréal, Québec.
10
Psychologist and Researcher, Clinique des troubles de l'humeur and Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Hôpital Rivière-des-Prairies, Montréal, Québec; Full Professor, Département de psychologie, Université du Québec à Montréal, Montréal, Québec; Associate Professor, Département de psychiatrie, Université de Montréal, Montréal, Québec.
11
Professor and Head, Département de psychiatrie, Université de Montréal, Montréal, Quebec; Professor and Head, Centre de recherche Fernand-Seguin et Clinique des troubles de l'humeur, Hôpital Rivière-des-Prairies, Montréal, Québec.
12
Professor and Department Head, Département de pédiatrie médicale, Fédération hospitalo-universitaire de psychiatrie de l'enfant et de l'adolescent (Centre Hospitalier universitaire de Rouen et Centre hospitalier du Rouvray, France) Rouen et Rouvray, France; Researcher, Laboratoire Psy-NCA-EA-4700, Université de Rouen, Rouen, France.

Abstract

OBJECTIVE:

To assess risk and protective factors for suicidality at 6-month follow-up in adolescent inpatients after a suicide attempt.

METHODS:

One hundred seven adolescents from 5 inpatient units who had a suicide attempt were seen at 6-month follow-up. Baseline measures included sociodemographics, mood and suicidality, dependence, borderline symptomatology, temperament and character inventory (TCI), reasons for living, spirituality, and coping scores.

RESULTS:

At 6-month follow-up, 41 (38%) subjects relapsed from suicidal behaviours. Among them, 15 (14%) had repeated a suicide attempt. Higher depression and hopelessness scores, the occurrence of a new suicide attempt, or a new hospitalization belonged to the same factorial dimension (suicidality). Derived from the best-fit structural equation modelling for suicidality as an outcome measure at 6-month follow-up, risk factors among the baseline variables included: major depressive disorder, high depression scores, and high scores for TCI self-transcendence. Only one protective factor emerged: coping-hard work and achievement.

CONCLUSION:

In this very high-risk population, some established risk factors (for example, a history of suicide attempts) may not predict suicidality. Our results suggest that adolescents who retain high scores for depression or hopelessness, who remain depressed, or who express a low value for life or an abnormally high connection with the universe are at higher risk for suicidality and should be targeted for more intense intervention. Improving adolescent motivation in school and in work may be protective. Given the sample size, the model should be regarded as exploratory.

PMID:
25886668
PMCID:
PMC4345845
[Indexed for MEDLINE]
Free PMC Article

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