Adolescents hospitalised with deliberate self-harm: the significance of an intention to die

Abstract

 All suicide attempters admitted to medical wards in the greater Oslo area, (n = 91) aged 13–19 years, were dichotomised on the basis of one item in the Motives for Parasuicide Questionnaire (MPQ) and one item in the Suicide Intent Scale (SIS): if the intent was to die (n = 57), or not (n = 34). The two groups were compared regarding the attempt, mental health problems, and psychosocial risk factors. The attempt of adolescents with an intent to die were more serious, rated with SIS (15.7 vs. 5.7, p < 0.001), with Risk Rescue Rating (p = 0.003) or rated medically (p < 0.05). They were clinically more often depressed (61% vs. 32%, p < 0.01), felt more hopeless (Hopelessness Scale) (10.8 vs. 8.2, p < 0.05), were less disruptive (11% vs. 32%, p < 0.05) and less often abused substances (0 vs. 12%, p < 0.05). Both groups were equally burdened with other factors. Differentiation on the basis of suicidal intent delineated two groups, both with considerable psychosocial problems. Those with suicide intent had more internalising problems including depression, while those with other intents showed more externalising behaviour. The need for help in the group with no intent to die may be underestimated.