Background

Dialectical behaviour therapy for adolescents (DBT-A) has recently been adapted and tested as an intervention for suicidal youth in randomized trials. Although studies have demonstrated the efficacy of this intervention for suicidal behaviours, research examining which youth get offered DBT-A in clinical practice is lacking.

Objective

This study aimed to determine the proportion of suicidal youth that were offered DBT-A in a child and youth psychiatric outpatient clinic, and how selected clinical features differ between youth offered and not offered DBT-A.

Method

Medical records of 44 youth were reviewed based on: (1) initial mental health intake assessment between January and June 2015, (2) age 13–16 years, and (3) active suicidal ideation (SI) with or without recent non-suicidal self-injury (NSSI)-or suicide attempt (SA). Twenty-four consecutive months of demographic, diagnostic, and treatment data were reviewed retrospectively.

Results

79.5% (n = 35) of the sample endorsed SI, 63.6% (n = 28) endorsed NSSI, and 47.7% (n = 21) reported a past SA. 47.7% (n = 21) were offered DBT-A. There was a significant relationship between offering of DBT-A and endorsement of multiple suicidal risk symptoms at baseline. Youth offered DBT-A reported significantly more types of adverse childhood experiences than those not offered DBT-A.

Conclusion

Youth mental health clinicians appear to preferentially offer DBT-A to youth who report multiple suicidal risk symptoms and adverse childhood experiences. This profile is consistent with populations of youth enrolled in randomized trials of DBT-A. A large proportion of suicidal youth are not offered DBT-A, suggesting that clinicians consider multiple factors in treatment decision-making.

中文翻译：

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有自杀风险的青少年的门诊精神病护理：谁被提供辩证行为疗法？

背景

青少年的辩证行为疗法（DBT-A）最近已进行调整，并在随机试验中作为对自杀青年的干预措施进行了测试。尽管研究表明该干预措施对自杀行为有效，但尚缺乏研究在临床实践中检查哪些青年获得DBT-A的研究。

目的

这项研究旨在确定在儿童和青年精神科门诊中接受DBT-A自杀的年轻人的比例，以及所选择的DBT-A和未接受DBT-A的年轻人之间所选择的临床特征有何不同。

方法

根据以下内容对44名青年的医疗记录进行了审查：（1）在2015年1月至2015年6月期间进行了初步的心理健康评估，（2）13-16岁，以及（3）有或没有近期未自杀的主动自杀意念（SI）自伤（NSSI）或自杀未遂（SA）。回顾了连续二十四个月的人口统计学，诊断和治疗数据。

结果

样本中有79.5％（n = 35）认可了SI，63.6％（n = 28）认可了NSSI，还有47.7％（n = 21）表示过去的SA。提供了47.7％（n = 21）的DBT-A。在基线时提供DBT-A与多种自杀风险症状的认可之间存在显着的关系。与未提供DBT-A的青少年相比，提供DBT-A的青少年报告的不良儿童经历类型明显更多。

结论

青年心理健康临床医生似乎优先向报告有多种自杀风险症状和不良童年经历的青年提供DBT-A。该概况与参加DBT-A随机试验的青年人群一致。绝大部分自杀青少年未获得DBT-A，这表明临床医生在治疗决策中考虑了多种因素。