Abstract
Objective: Psychiatric hospitalization is essential in the clinical management of suicidal adolescents, and a considerable number of hospitalized adolescents are rehospitalized, yet little is known about how this experience may influence postdischarge outcomes. This study examined the association between rehospitalization within three months of index hospitalization and subsequent suicide attempts and suicidal ideation among adolescents. Methods: Participants were 373 youths (13-17 years old) hospitalized because of suicide risk, and they were followed for one year. Using Cox regression, the investigators examined rehospitalization within three months of index hospitalization as a predictor of time to suicide attempt during the subsequent nine months. Using latent-class growth modeling, they also examined whether rehospitalization predicted a change in the nine-month course of three suicidal ideation trajectories (subclinical, elevated but fast declining, and chronically elevated). Results: Rehospitalization was associated with greater risk of suicide attempts, above the effects of key covariates. Rehospitalization also predicted distinct changes in suicidal ideation trajectories: Within the elevated-fast declining and chronically elevated groups, rehospitalization predicted increases in ideation during the follow-up, with larger magnitude for the chronic group. In contrast, rehospitalization was associated with a decrease in follow-up suicidal ideation in the subclinical group. Conclusions: Rehospitalization predicted a more severe course of suicide ideation for most of the adolescents, but it was protective for only a smaller subgroup with subclinical levels of ideation at index hospitalization. Our findings also suggest that rehospitalization is a strong indicator of future risk of suicide attempt. These findings have important implications for intervening with rehospitalized adolescents.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 332-338 |
| Number of pages | 7 |
| Journal | Psychiatric Services |
| Volume | 67 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2016 |
Funding
Support for this project was provided by grant R01 MH63881 and Midcareer Investigator Award K24MH77705 from the National Institute of Mental Health to Dr. King. The authors thank Sanjeev Venkataraman, M.D., and Paul Quinlan, M.D., for administrative and risk management support and Anne Kramer, M.S.W., A.C.S.W., Barbara Hanna, Ph.D., and Lois Weisse, R.N., for project management. The authors also thank the research staff, participating inpatient staff, and the adolescent participants and their parents and guardians.
ASJC Scopus subject areas
- Psychiatry and Mental health
