Clinical Differences Between Suicidal and Nonsuicidal Depressed Children and Adolescents
J Clin Psychiatry 2005;66(4):492-498
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To examine the clinical symptoms and
comorbid psychiatric disorders of depressed children and
adolescents with and without clinically significant suicidal
Method: Children and adolescents aged 7 to 17
years with current DSM-III-R major depressive disorder (MDD)
(N = 135) were recruited between January 1987 and April 2002.
Current MDD symptoms and lifetime comorbid psychiatric disorders
were assessed using either a combination of the Schedule for
Affective Disorders and Schizophrenia for School Age
Children-Epidemiologic and -Present Episode versions or the
Present Lifetime version. Thirty-two percent (N = 43) of the
depressed subjects were classified as suicidal (at least suicidal
ideation with a plan).
Results: Depressed suicidal youth presented with
a more severe episode (p = .001) and a poorer functional status
(p = .019), were more hopeless (p = .001), and presented more
frequently with insomnia (p = .011). There was an interaction
between suicide X sex X pubertal status for severity of MDD
(p = .013), the presence of hopelessness (p < .001), poor
functional status (p = .023), and comorbidity with a lifetime
history of any disruptive behavior (p = .019). Among prepubertal
depressed males, suicidal boys had significantly increased
severity of MDD (p = .025) and poorer functional status (p = .044)
than nonsuicidal boys. Among postpubertal depressed females,
suicidal girls were more frequently hopeless (p = .008) and
presented an increased severity of MDD (p = .022) and more frequent
lifetime history of any disruptive behavior (p = .03) when compared
with nonsuicidal girls.
Conclusion: There appears to be a sex
difference for some clinical features, particularly hopelessness,
among depressed suicidal children and adolescents. Whether
hopelessness is a sex-specific characteristic of depressed
suicidal children and adolescents requires further study.