The Treatment of Adolescent Suicide Attempters Study (TASA)

Predictors of Suicidal Events in an Open Treatment Trial

David A. Brent*, Laurence L. Greenhill, Scott Compton, Graham Emslie, Karen Wells, John T. Walkup, Benedetto Vitiello, Oscar Bukstein, Barbara Stanley, Kelly Posner, Betsy D. Kennard, Mary F. Cwik, Ann Wagner, Barbara Coffey, John S. March, Mark Riddle, Tina Goldstein, John Curry, Shannon Barnett, Lisa Capasso & 5 others Jamie Zelazny, Jennifer Hughes, Sa Shen, S. Sonia Gugga, J. Blake Turner

*Corresponding author for this work

Research output: Contribution to journalArticle

139 Citations (Scopus)

Abstract

Objective: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. Method: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral). Results: The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event. Conclusions: In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(10):987-996.

Original languageEnglish (US)
Pages (from-to)987-996
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume48
Issue number10
DOIs
StatePublished - Oct 1 2009

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Suicidal Ideation
Suicide
Depression
Therapeutics
Sex Offenses
Depressive Disorder
Psychotherapy
Psychiatry
Emergencies
Referral and Consultation
Safety

Keywords

  • depression
  • pharmacotherapy
  • psychotherapy
  • suicide attempt

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Brent, David A. ; Greenhill, Laurence L. ; Compton, Scott ; Emslie, Graham ; Wells, Karen ; Walkup, John T. ; Vitiello, Benedetto ; Bukstein, Oscar ; Stanley, Barbara ; Posner, Kelly ; Kennard, Betsy D. ; Cwik, Mary F. ; Wagner, Ann ; Coffey, Barbara ; March, John S. ; Riddle, Mark ; Goldstein, Tina ; Curry, John ; Barnett, Shannon ; Capasso, Lisa ; Zelazny, Jamie ; Hughes, Jennifer ; Shen, Sa ; Gugga, S. Sonia ; Turner, J. Blake. / The Treatment of Adolescent Suicide Attempters Study (TASA) : Predictors of Suicidal Events in an Open Treatment Trial. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2009 ; Vol. 48, No. 10. pp. 987-996.
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abstract = "Objective: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. Method: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral). Results: The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event. Conclusions: In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40{\%} of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(10):987-996.",
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Brent, DA, Greenhill, LL, Compton, S, Emslie, G, Wells, K, Walkup, JT, Vitiello, B, Bukstein, O, Stanley, B, Posner, K, Kennard, BD, Cwik, MF, Wagner, A, Coffey, B, March, JS, Riddle, M, Goldstein, T, Curry, J, Barnett, S, Capasso, L, Zelazny, J, Hughes, J, Shen, S, Gugga, SS & Turner, JB 2009, 'The Treatment of Adolescent Suicide Attempters Study (TASA): Predictors of Suicidal Events in an Open Treatment Trial', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 48, no. 10, pp. 987-996. https://doi.org/10.1097/CHI.0b013e3181b5dbe4

The Treatment of Adolescent Suicide Attempters Study (TASA) : Predictors of Suicidal Events in an Open Treatment Trial. / Brent, David A.; Greenhill, Laurence L.; Compton, Scott; Emslie, Graham; Wells, Karen; Walkup, John T.; Vitiello, Benedetto; Bukstein, Oscar; Stanley, Barbara; Posner, Kelly; Kennard, Betsy D.; Cwik, Mary F.; Wagner, Ann; Coffey, Barbara; March, John S.; Riddle, Mark; Goldstein, Tina; Curry, John; Barnett, Shannon; Capasso, Lisa; Zelazny, Jamie; Hughes, Jennifer; Shen, Sa; Gugga, S. Sonia; Turner, J. Blake.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 48, No. 10, 01.10.2009, p. 987-996.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Treatment of Adolescent Suicide Attempters Study (TASA)

T2 - Predictors of Suicidal Events in an Open Treatment Trial

AU - Brent, David A.

AU - Greenhill, Laurence L.

AU - Compton, Scott

AU - Emslie, Graham

AU - Wells, Karen

AU - Walkup, John T.

AU - Vitiello, Benedetto

AU - Bukstein, Oscar

AU - Stanley, Barbara

AU - Posner, Kelly

AU - Kennard, Betsy D.

AU - Cwik, Mary F.

AU - Wagner, Ann

AU - Coffey, Barbara

AU - March, John S.

AU - Riddle, Mark

AU - Goldstein, Tina

AU - Curry, John

AU - Barnett, Shannon

AU - Capasso, Lisa

AU - Zelazny, Jamie

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AU - Shen, Sa

AU - Gugga, S. Sonia

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N2 - Objective: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. Method: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral). Results: The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event. Conclusions: In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(10):987-996.

AB - Objective: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. Method: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two participants withdrew before treatment assignment. The remaining 124 youths received a specialized psychotherapy for suicide attempting adolescents (n = 17), a medication algorithm (n = 14), or the combination (n = 93). The participants were followed up 6 months after intake with respect to rate, timing, and predictors of a suicidal event (attempt or acute suicidal ideation necessitating emergency referral). Results: The morbid risks of suicidal events and attempts on 6-month follow-up were 0.19 and 0.12, respectively, with a median time to event of 44 days. Higher self-rated depression, suicidal ideation, family income, greater number of previous suicide attempts, lower maximum lethality of previous attempt, history of sexual abuse, and lower family cohesion predicted the occurrence, and earlier time to event, with similar findings for the outcome of attempts. A slower decline in suicidal ideation was associated with the occurrence of a suicidal event. Conclusions: In this open trial, the 6-month morbid risks for suicidal events and for reattempts were lower than those in other comparable samples, suggesting that this intervention should be studied further. Important treatment targets include suicidal ideation, family cohesion, and sequelae of previous abuse. Because 40% of events occurred with 4 weeks of intake, an emphasis on safety planning and increased therapeutic contact early in treatment may be warranted. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(10):987-996.

KW - depression

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