Jimmy Choi1, Jennifer Callaghan1, Melissa Deasy1, Linda Durst1, David Tolin1, Michael Stevens1, Godfrey Pearlson1; 1The Institute of Living at Hartford Hospital, Hartford, Connecticut, USA
The risk for self-harm in teenagers experiencing psychotic symptoms is an urgent clinical matter, as adolescents in this population are at much greater risk for suicide compared to the same group in the general population. Researchers have called for investigations into clinical markers specific to psychosis and this age group in hopes of developing therapeutic targets to mitigate suicide risk. In this cross-sectional study, we examined the prevalence of suicidality and predictors associated with recent suicidal ideation and past attempts in 58 adolescents ages 12 to 18 enrolled in the Connecting Adolescents with Psychosis (CAP) Program, an intensive day program for youth diagnosed with psychotic spectrum disorders. Results: Similar to other studies in this young population, a little more than half (n=30) reported mild to moderate suicidal ideation at intake, with nearly a third reporting a past attempt (n=19). Teenagers who endorsed delusions were 5 times more likely to endorse suicidal ideation (odds ratio[OR]=5.22; 95% CI, 3.27-9.81; p<0.01), while those with obsessive-compulsive symptoms were almost 4 times more likely to do so. Teenagers who endorsed “not true” on item 6 of the Maryland Assessment of Recovery Scale (“I feel accepted as who I am”) were 12 times more likely to report suicidal ideation. Notably, teenagers who endorsed all three items--delusions, OCD symptoms, and not feeling accepted by others--were 31 times more likely to endorse SI and report at least one past suicide attempt. Delusions, OCD symptoms, and perceptions of identity were robust predictors of suicide risk in teenagers with psychosis.
