Objective: 

The objective of the study was to help pediatricians understand and respond to suicidal ideation (SI) in adolescents based on data from 2 widely used screening measures that assessed SI and other psychosocial vulnerabilities in a large, national sample.

Methods: 

Adolescents (ages 11–17 years) completed the Patient Health Questionnaire Modified for Teenagers (PHQ-9M) using the Comprehensive Health and Decision Information System software before their well-child visits. Question 9 asks about past 2-week SI. Their parents filled out the Pediatric Symptom Checklist (PSC-17P), which screens for a broad range of psychosocial problems. Chi-square analyses and one-way analysis of variances assessed the relationship between SI and psychosocial problems.

Results: 

Among 5411 adolescents, 266 (4.9%) reported SI at least several days in the past 2 weeks. Among adolescents with SI, 187 (70.3%) reported moderate to very severe depression on the PHQ-9M (≥10), 68.1% were at risk on at least 1 PSC-17P problem subscale, 59.7% on the PSC-17P internalizing scale, 42.9% on PSC-17P overall, 20.6% on PSC-17P externalizing, and 18.5% on PSC-17P attention. Within the subsample endorsing SI nearly all days, 35.7% had a former suicide attempt.

Conclusion: 

The PHQ-9M identifies a clinically heterogeneous subset of approximately 5% of adolescents who report occasional to frequent SI. The PSC-17P corroborates their high degree of overall risk and offers additional information that can help pediatricians assess clinical severity and range of psychosocial problems. Given our limited knowledge of how to predict and prevent an individual adolescent's suicide, the focus of screening should be to identify and help the subset of patients with chronic psychosocial vulnerability of any type.

中文翻译：

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青少年的自杀意念：了解 PHQ-9M 和 PSC-17P 筛查的结果

客观的： 

该研究的目的是根据两种广泛使用的筛查措施的数据，帮助儿科医生了解和应对青少年的自杀意念（SI），这些筛查措施评估了大型全国样本中的自杀意念和其他社会心理脆弱性。

方法： 

青少年（11-17 岁）在儿童就诊前使用综合健康和决策信息系统软件完成了针对青少年修改的患者健康问卷 (PHQ-9M)。问题 9 询问过去 2 周的 SI。他们的父母填写了儿科症状检查表（PSC-17P），用于筛查广泛的心理社会问题。卡方分析和单向方差分析评估了 SI 与心理社会问题之间的关系。

结果： 

在 5411 名青少年中，266 名（4.9%）在过去两周内至少有几天报告了 SI。在患有 SI 的青少年中，187 名 (70.3%) 在 PHQ-9M (≥10) 上报告中度至极重度抑郁，68.1% 在至少 1 个 PSC-17P 问题分量表上有风险，59.7% 在 PSC-17P 内化量表上有风险，PSC-17P 总体占 42.9%，PSC-17P 外化占 20.6%，PSC-17P 关注占 18.5%。在几乎全天都支持 SI 的子样本中，35.7% 的人曾有过自杀企图。

结论： 

PHQ-9M 确定了大约 5% 的青少年的临床异质亚群，他们偶尔会频繁发生 SI。PSC-17P 证实了其高度的总体风险，并提供了额外的信息，可以帮助儿科医生评估临床严重性和心理社会问题的范围。鉴于我们对如何预测和预防青少年自杀的了解有限，筛查的重点应该是识别和帮助任何类型的慢性社会心理脆弱性患者。