@article{ref1, title="Frequent follow-up of suicidal youth assessed in the emergency room: long-term trajectory and predictors of suicidality", journal="Preventive medicine", year="2021", author="Greenfield, Brian and Jolicoeur-Martineau, Alexia and Brown, Maria and Kandiyoti, Alegra and Henry, Melissa and Sasson, Tania and Ahmadi, Shamila and Vivani, Tania and Harnden, Bonnie and de Castro, Filipa and Tran, Brian and Boodaghians, Levon and Weiss, Margaret and Atsaidis, Zoe and Wazana, Ashley", volume="152", number="Pt 1", pages="e106737-e106737", abstract="Suicide was the second‑leading cause of US deaths in 2018 among 15-24-year-olds. Suicide attempts, a risk factor for completions, and suicide ideation have doubled among pediatric emergency room (ER) patients during the past decade. Borderline Personality Disorder (BPD), a comorbid condition, has a 10% suicide rate. We examined the 4-year outcome of a cohort of suicidal adolescents, many also suffering from BPD and having undergone some form of treatment, to identify baseline factors which could inform intervention that would minimize suicidality 4 years post-discharge.

METHODS: We conducted a prospective longitudinal study of suicidality at twelve points (four assessment occasions) for 286 suicidal youth presenting to a pediatric ER, most suffering from BPD, with 36 suicide ratings from baseline to 2-, 6- and 48-month follow-up evaluations. We examined the trajectory and predictors of persisting suicidality.

RESULTS: Suicidality rapidly decreased within 2 months post-ER-discharge, subsequently remaining low throughout 48 months. Baseline functioning, female sex, stressful life events and BPD impulsiveness were most predictive of persisting suicidality at 48-month follow-up.

CONCLUSION: Most suicidal youth, many meeting BPD criteria, no longer feel suicidal 2 months after ER discharge. Management of participants' baseline poor functioning stressful life events and the impulsiveness component of BPD specifically in females could impact suicidality 4 years later, and guide treatment options. The absence of the BPD cognitive and affective subscales as predictors of suicidality at 4-year follow-up may reflect treatment received. Further investigation of treatment effects is warranted and under way.

Language: en

", language="en", issn="0091-7435", doi="10.1016/j.ypmed.2021.106737", url="http://dx.doi.org/10.1016/j.ypmed.2021.106737" }