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Published Online: 1 May 2011

Clinical and Psychosocial Predictors of Suicide Attempts and Nonsuicidal Self-Injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)

Abstract

Objective:

The authors assessed whether clinical and psychosocial factors in depressed adolescents at baseline predict suicide attempts and nonsuicidal self-injury over 28 weeks of follow-up.

Method:

Participants were 164 adolescents with major depressive disorder taking part in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Clinical symptoms, family function, quality of current personal friendships, and suicidal and nonsuicidal self-harm were assessed at baseline. Suicidal and nonsuicidal self-harm thoughts and behaviors were assessed during 28 weeks of follow-up.

Results:

High suicidality, nonsuicidal self-injury, and poor family function at entry were significant independent predictors of suicide attempts over the 28 weeks of follow-up. Nonsuicidal self-injury over the follow-up period was independently predicted by nonsuicidal self-injury, hopelessness, anxiety disorder, and being younger and female at entry.

Conclusions:

Both suicidal and nonsuicidal self-harm persisted in depressed adolescents receiving treatment in the ADAPT study. A history of nonsuicidal self-injury prior to treatment is a clinical marker for subsequent suicide attempts and should be as carefully assessed in depressed youths as current suicidal intent and behavior.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 495 - 501
PubMed: 21285141

History

Received: 17 May 2010
Revision received: 2 September 2010
Revision received: 9 November 2010
Accepted: 15 November 2010
Published online: 1 May 2011
Published in print: May 2011

Authors

Details

Paul Wilkinson, M.D., M.R.C.Psych.
From the Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, Cambridge, England; the Department of Child and Adolescent Psychiatry, Manchester University, Manchester, England; and the Royal Manchester Children's Hospital, Pendlebury, Manchester.
Raphael Kelvin, M.R.C.Psych.
From the Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, Cambridge, England; the Department of Child and Adolescent Psychiatry, Manchester University, Manchester, England; and the Royal Manchester Children's Hospital, Pendlebury, Manchester.
Chris Roberts, Ph.D.
From the Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, Cambridge, England; the Department of Child and Adolescent Psychiatry, Manchester University, Manchester, England; and the Royal Manchester Children's Hospital, Pendlebury, Manchester.
Bernadka Dubicka, M.D., M.R.C.Psych.
From the Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, Cambridge, England; the Department of Child and Adolescent Psychiatry, Manchester University, Manchester, England; and the Royal Manchester Children's Hospital, Pendlebury, Manchester.
Ian Goodyer, M.D., F.R.C.Psych.
From the Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, Cambridge, England; the Department of Child and Adolescent Psychiatry, Manchester University, Manchester, England; and the Royal Manchester Children's Hospital, Pendlebury, Manchester.

Notes

Address correspondence and reprint requests to Dr. Wilkinson, Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, Cambridge CB2 2AH, UK; [email protected] (e-mail).

Funding Information

The authors report no financial relationships with commercial interests.Supported by grant 97/29/01 from the U.K. National Health Service Health Technology Assessment Programme.

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