ARTICLE
Psychiatric Symptoms and Their Relationship to Suicidal Ideation in a High-Risk Adolescent Community Sample

https://doi.org/10.1097/00004583-200201000-00010Get rights and content

ABSTRACT

Objective

The purpose of the current study was to investigate the importance of diagnostic factors in the prediction of adolescent suicidal ideation in a high-risk community sample.

Method

Seventy-three high school students, aged 14 to 18 years, identified by school personnel as exhibiting emotional disturbance participated in the study. Psychiatric disorders were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version 5, and suicidal ideation with the Modified Scale for Suicidal Ideation.

Method

Seventy-four percent of the sample met criteria for a psychiatric disorder. Continuous measures of psychiatric symptoms provided stronger prediction of suicidal ideation than dichotomous measures. In particular, severity of symptoms associated with mood disorders afforded the strongest prediction of suicidal ideation. Moreover, although significantly related to suicidal ideation at the bivariate level, symptoms associated with disruptive behavior, anxiety, and substance use disorders did not predict suicidal ideation over and above mood disorder symptoms.

Conclusions

Adolescents presenting with emotional disturbance should be carefully screened for depression given the strong relationship between depressive symptoms and suicidal ideation. Furthermore, improved prediction of suicidal ideation may be obtained through the utilization of continuous measures of psychiatric symptoms in suicide research.

Section snippets

Sample

One hundred ten adolescents enrolled in one of three public high schools in Virginia were asked to participate in the study on a voluntary basis. Adolescents were selected on the basis of referrals obtained from school psychologists, guidance counselors, and special education teachers. These school personnel were asked to identify adolescents who exhibited any type of emotional disturbance in the school setting. Of those referred, 13 parents refused to allow their child to participate, 5

Psychiatric Diagnoses

Seventy-four percent of the adolescents received a diagnosis as assessed by the K-SADS-E, yielding a total of 121 diagnoses. The frequencies and percentages of adolescents with current Axis I diagnoses are given in Table 1. In interpreting these results, it is important to note that the prevalence of specific disorders included adolescents who had more than one disorder.

Demographic Differences

No significant differences across age, grade, or race were found in level of suicidal ideation as measured by the MSSI.

DISCUSSION

Seventy-four percent of adolescents included in this high-risk high school sample received a psychiatric diagnosis. The most prevalent diagnosis was MDD, with approximately 40% of adolescents meeting diagnostic criteria. These prevalence estimates are higher than those reported by Lewinsohn et al. (1993), who found that only 10% of adolescents in a randomly selected high school sample had a psychiatric diagnosis. Furthermore, approximately 56% of adolescents included in this study reported

REFERENCES (25)

  • GA Clum et al.

    Additional support for the reliability and validity of the Modified Scale for Suicidal Ideation

    Psychol Assess

    (1995)
  • C Edelbrock et al.

    Age differences in reliability of the psychiatric interview of the child

    Child Dev

    (1985)
  • Cited by (0)

    This study was sponsored by a small institutional grant from Virginia Tech.

    View full text