Characteristics of suicidal ideation that predict the transition to future suicide attempts in adolescents.

Abstract

__Background—The present study sought to examine characteristics of suicidal ideation (SI) that predict a future suicide attempt (SA), beyond psychiatric diagnosis and previous SA history. __Methods—Participants were 506 adolescents (307 female) who completed the Columbia Suicide Screen (CSS) and selected modules from the Diagnostic Interview Schedule for Children (C-DISC 2.3) as part of a 2-stage high-school screening and who were followed up 4-6 years later to assess for a SA since baseline. At baseline, participants who endorsed SI on the CSS responded to four questions regarding currency, frequency, seriousness, and duration of their SI. A subsample of 122 adolescents that endorsed SI at baseline also completed a detailed interview about their most recent SI. __Results—Thinking about suicide often (OR = 3.5, 95% CI = 1.7-7.2), seriously (OR = 3.1, 95% CI = 1.4-6.7), and for a long time (OR = 2.3, 95% CI = 1.1-5.2) were associated with a future SA, adjusting for sex, the presence of a mood, anxiety, and substance use diagnosis, and baseline SA history. However, only SI frequency was significantly associated with higher odds of a future SA (OR = 3.6, 95% CI = 1.4-9.1) when also adjusting for currency, seriousness, and duration. Among ideators interviewed further about their most recent SI, ideating 1 hour or more (vs. less than 1 hour) was associated with a future SA (OR = 3.6, 95% CI = 1.0-12.7), adjusting for sex, depressive symptoms, previous SA history, and other baseline SI characteristics, and it was also associated with making a future SA earlier. __Conclusions—Assessments of SI in adolescents should take special care to inquire about frequency of their SI, along with length of their most recent SI.