Citation

King CA, Brent DA, Grupp-Phelan J, Shenoi R, Page K, Matabele-Gittens EM, Chernick LS, Melzer-Lange M, Rea M, McGuire TC, Littlefield A, Casper TC. J. Am. Acad. Child Adolesc. Psychiatry 2019; ePub(ePub): ePub.

Affiliation

University of Utah School of Medicine, Salt Lake City, UT.

Copyright

(Copyright © 2019, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2019.10.015

PMID

31830523

Abstract

OBJECTIVE: Adolescents at risk for suicide are highly heterogeneous in terms of psychiatric and social risk factors, yet there has been little systematic research on risk profiles, which would facilitate recognition and the matching of patients to services. Our primary study aims were to identify latent class profiles of adolescents with elevated suicide risk, and to examine the association of these profiles with mental health service use (MHSU).

METHOD: Participants were 1,609 adolescents from the Emergency Department Screen for Teens at Risk for Suicide (ED-STARS) cohort. Participants completed baseline surveys assessing demographics, MHSU, and suicide risk. Telephone follow-up interviews were conducted at 3-months to assess suicide attempts. Participants met pre-established baseline criteria for suicide risk.

RESULTS: Using latent class analysis, we derived five profiles of elevated suicide risk with differing patterns of eight risk factors: history of multiple suicide attempts, past-month suicidal ideation, depression, alcohol and drug misuse, impulsive-aggression, and sexual and physical abuse. In comparison to adolescents who did not meet baseline criteria for suicide risk, each profile was associated with increased risk of a suicide attempt within 3 months. MHSU was lowest for adolescents fitting profiles with previous (but no recent) suicidal thoughts and behavior and for adolescents from racial and ethnic minority groups.

CONCLUSION: Adolescents at elevated risk for suicide present to EDs with differing profiles of suicide risk. MHSU varies across these profiles and by race/ethnicity, indicating that targeted risk recognition and treatment linkage efforts may be necessary to reach some adolescents at risk.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

adolescence; latent class profiles; mental health service use; suicide risk