CohortJournal of developmental and behavioral pediatrics : JDBP2022

Suicidal Ideation in Adolescents: Understanding Results from Screening with the PHQ-9M and the PSC-17P.

Juliana M Holcomb, Anamika Dutta, Paul Bergmann and 7 others

PMID 35125467

WHAT IT FOUND

Adolescents reporting suicidal thoughts on routine depression screens had widespread psychosocial issues, not just depression.

As thought frequency increased, rates of attention and conduct problems rose sharply. These results suggest treating such youth as having chronic psychosocial distress rather than focusing solely on imminent suicide risk.

Key findings

01Among adolescents with suicidal thoughts at least several days, 80.1% were at risk on psychosocial or depression screens, with 45.1% flagged for overall psychosocial risk.

02Higher frequency of suicidal thoughts was associated with a dramatic increase in lifetime suicide attempts, rising from 1.9% in those without thoughts to 35.7% in those with daily thoughts.

03Youth with frequent suicidal thoughts showed significantly more attention and externalizing problems compared to peers with less frequent thoughts, indicating broader dysfunction.

STILL TO COME

How it was doneWhat they found

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What it does not show

The cross-sectional design means the study cannot predict which adolescents will attempt suicide in the future or track how ideation changes over time. The data lacked information on race, ethnicity, socioeconomic status, gender identity, and sexual orientation, limiting understanding of disparities. Screenings were completed in primary care settings, so results may not apply to adolescents in mental health or emergency care. Some questionnaires were completed up to two weeks before the visit, which may affect the immediacy of the risk assessment.

Declared interests

One author developed the CHADIS platform used for data collection and has financial interests in it. The study was supported by the National Institutes of Health.

The easy way to misread this

Do not interpret a positive suicidal ideation screen as a prediction of imminent suicide attempt. The study found no evidence that screening predicts individual future attempts, and many adolescents who attempt suicide do not report ideation on the PHQ-9M.

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The study

Participants
5,411 adolescents
Certainty of evidence
Low

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    Juliana M Holcomb, Anamika Dutta, Paul Bergmann, et al. Suicidal Ideation in Adolescents: Understanding Results from Screening with the PHQ-9M and the PSC-17P. Journal of developmental and behavioral pediatrics : JDBP. 2022.

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