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Practice Corner: Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients

Practice Corner Author: Kourtney L. Schroeder, Nova Southeastern University

Article Title: Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients

Article Authors: Adam G. Horwitz, Ewa K. Czyz, & Cheryl A. King

Why is this article relevant to practice?

Many studies focus on the suicidality of adolescents in a general outpatient setting, while this study targets a subset of young people who present to the hospital for a psychiatric emergency. Not only does this article examine risk factors associated with potential suicide risk of those adolescents and young adults in a hospital setting, it also presents a screening tool that is helpful to use in the screening process as well as every day practice.

What are the key takeaways from the article?

  • Longitudinal examination of characteristics of suicidal ideation in participants who present for a psychiatric emergency and have history of suicide attempts and para-suicidal self-injury behavior
  • Assessment of 473 participants in the Midwestern United States aged 15-24 was conducted over an 18-month period using the Columbia-Suicide Severity Rating Scale (which had been validated for an adolescent population), examination of medical records, and follow-up visits
  • Male gender was found to moderate duration of suicidal ideation and future attempts
  • Risk factors for suicidal behavior included severity and intensity of ideation, lifetime number of suicide attempts, and lifetime number/frequency of non-suicidal self-injurious behaviors

What do the authors say are the limitations of the article?

  • Only one clinician administered the C-SSRS, therefore lack of interrater reliability
  • Authors indicated there was no examination of participants’ race or ethnicity, which decreases the ability to generalize to other populations
  • Authors note there may be an underestimation of suicide attempts during follow-up period since the assumption was made that the participants who did not return for follow-up had not made suicide attempts
  • Experts reported a lack of statistical power due to small number of people (34) endorsing a previous suicide attempt in 18-month period

Helpful links: http://cssrs.columbia.edu/

https://secure.trainingcampus.net/uas/modules/trees/windex.aspx?rx=c-ssrs.trainingcampus.net&

Link to the article: https://www.tandfonline.com/doi/full/10.1080/15374416.2014.910789

Full Article Reference: Horwitz, A. G., Czyz, E. K., & King, C. A. (2015). Predicting future suicide attempts among adolescent and emerging adult psychiatric emergency patients. Journal of Clinical Child & Adolescent Psychology44(5), 751-761.

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