Objective

Adolescents at risk for suicide are highly heterogeneous in terms of psychiatric and social risk factors, yet there has been little systematic research on risk profiles, which would facilitate recognition and the matching of patients to services. Our primary study aims were to identify latent class profiles of adolescents with elevated suicide risk, and to examine the association of these profiles with mental health service use (MHSU).

Method

Participants were 1,609 adolescents from the Emergency Department Screen for Teens at Risk for Suicide (ED-STARS) cohort. Participants completed baseline surveys assessing demographics, MHSU, and suicide risk. Telephone follow-up interviews were conducted at 3 months to assess suicide attempts. Participants met pre-established baseline criteria for suicide risk.

Results

Using latent class analysis, we derived 5 profiles of elevated suicide risk with differing patterns of eight risk factors: history of multiple suicide attempts, past-month suicidal ideation, depression, alcohol and drug misuse, impulsive-aggression, and sexual and physical abuse. In comparison to adolescents who did not meet baseline criteria for suicide risk, each profile was associated with increased risk of a suicide attempt within 3 months. The MHSU was lowest for adolescents fitting profiles with previous (but no recent) suicidal thoughts and behavior, and for adolescents from racial and ethnic minority groups.

Conclusion

Adolescents at elevated risk for suicide present to emergency departments with differing profiles of suicide risk. MHSU varies across these profiles and by race/ethnicity, indicating that targeted risk recognition and treatment linkage efforts may be necessary to reach some adolescents at risk.

中文翻译：

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青少年自杀未遂风险升高的五种情况：心理健康服务使用的差异。

客观的

有自杀风险的青少年在精神和社会风险因素方面具有高度异质性，但几乎没有关于风险概况的系统研究，这将有助于识别和匹配患者与服务。我们的主要研究目的是确定自杀风险升高的青少年的潜在类别概况，并检查这些概况与心理健康服务使用 (MHSU) 的关联。

方法

参与者是来自急诊科青少年自杀风险筛查 (ED-STARS) 队列的 1,609 名青少年。参与者完成了评估人口统计学、MHSU 和自杀风险的基线调查。在 3 个月时进行电话随访，以评估自杀企图。参与者符合预先设定的自杀风险基线标准。

结果

使用潜在类别分析，我们得出了 5 个具有不同模式的自杀风险升高的 8 个风险因素的特征：多次自杀未遂史、过去一个月的自杀意念、抑郁、酒精和药物滥用、冲动攻击以及性虐待和身体虐待。与不符合自杀风险基线标准的青少年相比，每种情况都与 3 个月内企图自杀的风险增加有关。MHSU 对于符合先前（但最近没有）自杀想法和行为的青少年以及来自种族和少数民族群体的青少年而言最低。

结论

到急诊室就诊的自杀风险较高的青少年具有不同的自杀风险特征。MHSU 因这些概况和种族/民族而异，这表明可能需要有针对性的风险识别和治疗联系工作才能接触到一些有风险的青少年。