Adjustment disorder and the course of the suicidal process in adolescents

Abstract

Background: Adjustment disorders are often associated with suicidal behaviour but there is little information regarding the nature of the relationship and the effect of adjustment disorders on the suicidal process. The authors' goal was to investigate the association of adjustment disorders (with depressed mood) and suicide in adolescents by means of a psychological autopsy study. Method: Relatives and other informants of 19 suicide victims were interviewed by means of a semi-structured interview schedule. Differences in duration of the suicidal process between suicide victims diagnosed with adjustment disorder and suicide cases diagnosed with other psychiatric disorders were examined. Results: The suicidal process was significantly shorter in suicide victims diagnosed with adjustment disorder compared with suicide cases diagnosed with other disorders. No indications of a history of emotional or behavioural problems during early adolescence were found in suicide cases diagnosed with adjustment disorder. Limitations: The study sample consists of a small sample size and retrospective interviews of relatives were used. Conclusions: The suicidal process in suicide victims diagnosed with adjustment disorder appears to be short and rapidly evolving without any prior indications of emotional or behavioural problems. The importance of assessing the suicidal risk in patients diagnosed with adjustment disorder is underlined. D

Suicide among Italian adolescents: 1970–2002

“…Stressful life events accounted for 14% of the deaths and 15% were classified as a result of experimentation, with half of these deaths due to using drugs or alcohol. In a psychological autopsy study of suicide deaths of 19 young people in Belgium [23], the authors identified a subset of young people who had no previous behavioral or emotional difficulties but who completed suicide following the development of an adjustment disorder [22]. A case-control psychological autopsy study by Shaffer et al [27] examined 120 consecutive suicides (mean age 16 years) in an ethnically diverse area of the United States.…”

Suicidal behaviours in adjustment disorder and depressive episode

“…7 Suicidal behaviours occur earlier in the course of AD than in DE, 6 as does suicide. 8,9 All aspects of suicidality, including suicidal ideation, behaviour or death by suicide have been under researched in AD, instead focussing on DE and other mood disorders. 7 This neglect is surprising considering suicidality is commonly associated with AD in the emergency department (ED) 10 and among among those admitted for in-patient psychiatric treatment.…”

The suicidal process: age of onset and severity of suicidal behaviour

“…Similarly, movement from a death wish through to a suicide attempt has been interpreted as a hierarchy of intent [2], and a number of authors have discussed this under the general concept of ''the suicidal process'' [3][4][5]-the term adopted here.…”