Key Takeaways

From the Authors As published in the article
  1. There is an association between posttraumatic stress disorder (PTSD) with a history of sexual abuse and a higher prevalence of major depressive disorder and substance use disorder, which can ultimately increase the risk of suicide.
  2. Clinicians should be vigilant for suicidality in patients with PTSD with a history of sexual abuse and identify those at greater risk for suicide, which could be a practical approach to prevention.
Extended Takeaways
  1. In this inpatient PTSD cohort, sexual abuse history was associated with a higher unadjusted rate of suicidal ideation/attempt (35.4% vs 29.8%, P = .05), but the association was not significant after adjustment (OR = 1.16, P = .29), suggesting that comorbid burden may account for much of the excess risk.
  2. Major depressive disorder was one of the strongest independent predictors of suicidal ideation/attempt in hospitalized youth with PTSD (OR = 1.66, P < .001), so active assessment and treatment of depression should be a priority during inpatient evaluation.
  3. Female sex independently increased suicidal ideation/attempt risk (OR = 1.50, P < .001), and the PTSD with sexual abuse group was predominantly female (80.9% vs 66.3%, P < .001), which may help identify a subgroup needing especially close monitoring.
  4. Anxiety disorders other than PTSD were also more common in the PTSD with sexual abuse group (P = .01), indicating that clinicians should broaden the diagnostic assessment beyond core PTSD symptoms when evaluating these patients.
  5. The PTSD with sexual abuse group had greater illness severity, with major loss of function recorded in 100% of hospitalizations versus 61.1% in PTSD only patients (P < .001), underscoring the need for more intensive inpatient management and discharge planning.
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