Neera Ghaziuddin1, Christopher Merchant2, Richard Dopp3, Cheryl King4. 1. University of Michigan, Ann Arbor, United States. Electronic address: neerag@med.umich.edu. 2. Northeastern Illinois University, Chicago, United States. Electronic address: C-Merchant@neiu.edu. 3. University of Michigan, Ann Arbor, United States. Electronic address: dopp@med.umich.edu. 4. University of Michigan, Ann Arbor, United States. Electronic address: kingca@umich.edu.
Abstract
OBJECTIVE: Describe suicidal ideation and suicide related/other emergencies (SRE), among depressed and acutely suicidal adolescents during a 3-month period following psychiatric hospitalization. METHODS: One hundred twenty adolescents, who were both depressed and suicidal, were receiving an SSRI either alone or in combination with other medications, remained on a consistent medication regimen between baseline and at 3-months and their 3-month outcome data were available. The participants were divided into four medication groups: SSRI antidepressant only (n=71); SSRI plus mood stabilizer (n=17); SSRI plus antipsychotic (n=20); and SSRI plus antipsychotic and mood stabilizer (n=12). Standardized instruments were used. RESULTS: Mean age=15.5±1.3, Caucasian=80.8%, female=74.2%, mean CDRS-R=61.7±12.1, suicide attempt during month prior to hospitalization=58.6%. During the 3-month post-hospitalization period: (1) there were no suicides, six participants (5%) attempted suicide and 21 (17.5%) experienced an SRE; (2) decline in suicidal ideation and depression severity was noted; (3) SSRI plus an antipsychotic group reported the highest number of SREs; (4) higher baseline hopelessness and aggression scores were associated with greater reduction in suicidal ideation at 3-months. CONCLUSION: Declines in suicidal ideation, depression severity, and suicide attempts were noted, irrespective of psychotropic-combination received. A higher rate of SREs was associated with receiving an antipsychotic agent in combination with an SSRI. Given naturalistic design of study, cause-effect conclusions cannot be drawn. The lack of an objective measure to identify medication adherence is a study limitation.
OBJECTIVE: Describe suicidal ideation and suicide related/other emergencies (SRE), among depressed and acutely suicidal adolescents during a 3-month period following psychiatric hospitalization. METHODS: One hundred twenty adolescents, who were both depressed and suicidal, were receiving an SSRI either alone or in combination with other medications, remained on a consistent medication regimen between baseline and at 3-months and their 3-month outcome data were available. The participants were divided into four medication groups: SSRI antidepressant only (n=71); SSRI plus mood stabilizer (n=17); SSRI plus antipsychotic (n=20); and SSRI plus antipsychotic and mood stabilizer (n=12). Standardized instruments were used. RESULTS: Mean age=15.5±1.3, Caucasian=80.8%, female=74.2%, mean CDRS-R=61.7±12.1, suicide attempt during month prior to hospitalization=58.6%. During the 3-month post-hospitalization period: (1) there were no suicides, six participants (5%) attempted suicide and 21 (17.5%) experienced an SRE; (2) decline in suicidal ideation and depression severity was noted; (3) SSRI plus an antipsychotic group reported the highest number of SREs; (4) higher baseline hopelessness and aggression scores were associated with greater reduction in suicidal ideation at 3-months. CONCLUSION: Declines in suicidal ideation, depression severity, and suicide attempts were noted, irrespective of psychotropic-combination received. A higher rate of SREs was associated with receiving an antipsychotic agent in combination with an SSRI. Given naturalistic design of study, cause-effect conclusions cannot be drawn. The lack of an objective measure to identify medication adherence is a study limitation.
Authors: Charles B Nemeroff; Amir Kalali; Martin B Keller; Dennis S Charney; Susan E Lenderts; Elisa F Cascade; Hugo Stephenson; Alan F Schatzberg Journal: Arch Gen Psychiatry Date: 2007-04
Authors: Robert D Gibbons; C Hendricks Brown; Kwan Hur; Sue M Marcus; Dulal K Bhaumik; Joëlle A Erkens; Ron M C Herings; J John Mann Journal: Am J Psychiatry Date: 2007-09 Impact factor: 18.112
Authors: David A Brent; Graham J Emslie; Greg N Clarke; Joan Asarnow; Anthony Spirito; Louise Ritz; Benedetto Vitiello; Satish Iyengar; Boris Birmaher; Neal D Ryan; Jamie Zelazny; Matthew Onorato; Betsy Kennard; Taryn L Mayes; Lynn L Debar; James T McCracken; Michael Strober; Robert Suddath; Henrietta Leonard; Giovanna Porta; Martin B Keller Journal: Am J Psychiatry Date: 2009-02-17 Impact factor: 18.112
Authors: Jeffrey A Bridge; Satish Iyengar; Cheryl B Salary; Rémy P Barbe; Boris Birmaher; Harold Alan Pincus; Lulu Ren; David A Brent Journal: JAMA Date: 2007-04-18 Impact factor: 56.272