Suicidal adolescent out-patients were compared with non-suicidal subjects with respect to background factors, psychopathology and treatment received. Data for suicidal ideation, suicide attempts, psychiatric diagnoses (DSM-III-R) and other patient-related factors were collected prospectively during treatment of 122 male and 138 female out-patients aged 12-22 years. In total, 42% of subjects displayed suicidal tendencies, and 18% had attempted suicide. According to polychotomous regression, mood disorder, previous psychiatric treatment and low level of psychosocial functioning at treatment entry were associated with suicide attempts and with suicidal ideation for both sexes. Suicidal patients were more often receiving psychotropic medication and had more total appointments (mean number 15 vs. 9) than non-suicidal patients. Suicidal and non-suicidal patients kept their scheduled appointments to the same extent (66% vs. 65%). Treatments which meet the needs of disordered suicidal adolescents need to be developed.

The patients' level of psychosocial functioning and capability to work in young adulthood were associated with long-term prognosis in terms of working capacity. Adolescence seems to be the critical time for intensive psychiatric care combined with vocational rehabilitation programmes.

On admission, IgA, IgG and IgM concentrations were determined in 76 schizophrenics, and the correlations of these concentrations to the variables relating to psychopathology, background and prognosis were investigated in the present study, which is a part of a more extensive unpublished study. On the basis of factorization, the highest IgM concentrations were found in withdrawn schizophrenics and the lowest in paranoid schizophrenics. Of the background variables, the patient's present age had a positive correlation and his place of birth (rural-urban) a negative correlation to IgA concentrations, both being at a statistically significant level. IgA and IgM values higher than average at the beginning of treatment predicted a short hospital stay. Earlier, these patients had also needed little hospital care in relation to the duration of the disease. A hypothesis based on the results is presented, according to which a different way of reacting to stress may explain the differences in IgM concentrations in withdrawn and paranoid schizophrenics. The connection between prognosis and immunoglobulins was considered at least partially explainable on the grounds of age at the onset of the disease.

Mortality among 156 males and 122 females referred to an out-patient adolescent psychiatric clinic in a Finnish town between 1984 and 1989 was examined. During the follow-up (mean duration 6 years; range 0-6.3 years for the deceased, 0.6-10.3 years for the survivors), 16 male subjects but no females had died. Among those who had died, the mode of death was suicide in 11 cases. The mortality for any cause for males was 10.3% and that for suicide was 7.1%. All male victims had similar high levels of individual and familial disturbances. Current suicidal ideation and suicide attempts, poor psychosocial functioning and a recommendation for psychiatric hospital treatment during the index treatment were associated with male mortality/suicidality. A high risk for mortality for several years after psychiatric treatment was found. It is concluded that, in clinical settings, perceived current suicidal tendencies should be assessed carefully.

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