The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to 13 years (n = 1,825 assessments). Semistructured psychiatric diagnostic instruments were administered at repeated assessments to assess psychiatric disorders and suicide attempts. After controlling for demographic variables and prehospitalization suicide attempts, most contemporaneous psychiatric disorders (major depressive disorder [MDD], dysthymic disorder, generalized anxiety disorder [GAD], panic disorder, attentiondeficit/hyperactivity disorder [AD/HD], conduct disorder, and substance use disorder [SUD]) were related to increased risk of attempts. The relationship between suicide attempts and MDD, GAD, AD/HD, and SUD strengthened as participants got older. MDD, dysthymic disorder, GAD, and panic disorder were more commonly associated with repeat than 1st-time suicide attempts. In sum, most major psychiatric disorders are associated with increased risk for suicide attempts, but the strength of the relationships between these disorders and attempts changes over the course of development.
NIH-PA Author ManuscriptNIH-PA Author Manuscript
NIH-PA Author ManuscriptAccording to the National Strategy for Suicide Prevention, suicide attempts among adolescents and young adults occur at alarming rates, pose significant public health costs and burden, and are associated with increased likelihood for repeat suicide attempts and eventual death by suicide (U.S. Public Health Service, 2001). In efforts to better understand factors associated with increased risk for suicidal behavior, several community studies have examined the relationship between current psychiatric disorder and lifetime history of suicide attempts among adolescents (Andrews & Lewinsohn, 1992;Gould et al., 1998;Velez & Cohen, 1988). In studies focusing on lifetime histories of suicidal behavior, however, previous suicidal behavior may have occurred prior to the onset of the current psychiatric disorders (Foley, Goldston, Costello, & Angold, 2006). With cross-sectional studies of clinical samples, it has been possible to examine the relationships between psychiatric disorders and suicidal behavior occurring in the same window of time (e.g., Goldston et al., 1998). However, the period of time preceding hospitalization or entry into treatment is likely atypical, even for the highest risk young people.Longitudinal studies of psychiatric disorders and suicidal behavior may help clarify proximal associations because they offer the opportunity to examine relationships between suicidal behaviors and psychiatric disorders occurring in the same period of time, without the biases associated with one-time assessments in clinical settings. In the seminal community longitudinal study of Lewinsohn, Rohde, Seeley, and Ba...
