Lesbian, gay, bisexual, and transgender (LGBT) youth are at elevated risk for self-injurious thoughts and behaviors (SITBs). However, few studies have comprehensively examined SITBs and their longitudinal course in LGBT youth at high risk for suicide. The aims of the present study were to characterize histories of SITBs among high-risk LGBT youth and to examine prospective associations with suicidal behavior. Participants were 285 youth (41.8% LGBT) ages 13-25 years receiving psychiatric emergency department (ED) services. Post-discharge suicidal behavior was assessed via 4-month phone interviews and 12 month chart reviews. The sample was 42.1% male, 57.9% female, 2.5% gender minority, 41.8% sexual minority. LGBT participants were more likely to have prior psychiatric ED visits and hospitalizations, more frequent past week suicide ideation, and more severe nonsuicidal self-injury (NSSI). We conducted stratified survival analyses to identify predictors of time to suicidal behavior post discharge. The final model for LGBT youth included past week suicide ideation and past month NSSI episodes. Among non-LGBT youth, the final model included number of lifetime NSSI methods and use of a highly lethal suicide attempt method. Within this sample of youth receiving psychiatric emergency services, LGBT youth were overrepresented and had more severe histories of SITBs. Results suggest the importance of assessing both lifetime and recent factors (i.e., past week and month), particularly for LGBT youth. Future research should replicate these findings in larger samples to explore whether there are unique risk factors that can aid in predicting and preventing suicide among LGBT youth.

中文翻译：

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预测接受精神科急救服务的女同性恋，男同性恋，双性恋和变性者的自杀行为。

女同性恋，男同性恋，双性恋和变性者（LGBT）青年遭受自残性思想和行为（SITB）的风险较高。但是，很少有研究对自杀高风险的LGBT青年中的SITB及其纵向走向进行全面检查。本研究的目的是表征高危LGBT青年中SITB的历史，并研究与自杀行为的前瞻性关联。参加者有285例13-25岁的青年（41.8％的LGBT）接受了精神病急诊服务。出院后的自杀行为通过4个月的电话采访和12个月的图表回顾进行了评估。样本是男性的42.1％，女性的57.9％，性别的2.5％，性别的41.8％。LGBT参与者更有可能事先接受过精神科急诊就诊和住院，过去一周自杀意念的发生频率更高，以及更严重的非自杀性自残（NSSI）。我们进行了分层生存分析，以确定出院后自杀行为时间的预测因素。LGBT青年的最终模型包括过去一周的自杀观念和过去一个月的NSSI事件。在非LGBT青年中，最终模型包括终身使用的NSSI方法的数量以及使用高度致命的自杀未遂方法。在接受精神科急诊服务的青年样本中，LGBT青年人数过多，并且有更严重的SITB历史。结果表明，评估寿命和近期因素（即过去一周和一个月）的重要性，尤其是对于LGBT青年而言。未来的研究应该在更大的样本中重复这些发现，以探索是否存在可以帮助预测和预防LGBT青年自杀的独特危险因素。