The Treatment of Adolescent Suicide Attempters Study (TASA): Predictors of Suicidal Events in an Open Treatment Trial

University of Pittsburgh, Western Psychiatric Institute & Clinic, Pittsburgh, PA 15213, USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 7.26). 09/2009; 48(10):987-96. DOI: 10.1097/CHI.0b013e3181b5dbe4
Source: PubMed


To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial.
Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral).
The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event.
In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted.

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Available from: Kelly Posner, Dec 27, 2013
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    • "In the Treatment of SSRI-resistant Depression in Adolescents (TORDIA) study, 5% of treatment-resistant depressed adolescents made a suicide attempt in the first 12 weeks (Brent et al. 2009), suggesting a slightly lower occurrence than in our current sample, given the lower rate and longer time frame. Among psychiatrically hospitalized adolescents in the Youth-Nominated Support Team – Version II (YST-II) study, 18.5% made a suicide attempt over a 1 year period (King et al. 2009a); however, only 7.4% had made a suicide attempt during the first 3 months of the study (Czyz et al. 2014). "
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