Suicide-related events among child and adolescent patients during short-term antidepressant therapy
Article first published online: 20 APR 2011
© 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences
Volume 65, Issue 3, pages 239–245, April 2011
How to Cite
Kuba, T., Yakushi, T., Fukuhara, H., Nakamoto, Y., Singeo Jr, S. T., Tanaka, O. and Kondo, T. (2011), Suicide-related events among child and adolescent patients during short-term antidepressant therapy. Psychiatry and Clinical Neurosciences, 65: 239–245. doi: 10.1111/j.1440-1819.2011.02204.x
- Issue published online: 20 APR 2011
- Article first published online: 20 APR 2011
- Received 14 June 2010; revised 31 January 2011; accepted , 2 February 2011.
- baseline background;
- child and adolescent psychiatry;
- suicide-related events
Aims: Antidepressants have been of limited use for adolescent subjects with depression because of drug-induced suicide-related events (SRE). Therefore, we investigated actual suicidality and its risk factors during antidepressant therapy among child and adolescent patients in clinical settings.
Methods: The risks of SRE, consisting of suicidal ideation, self-mutilation and suicide attempt, were prospectively monitored among 70 child and adolescent patients (15.4 ± 2.8 years) during the first 3 months of antidepressant therapy.
Results: The proportion of SRE decreased from 47.1% to 22.9% after the treatment. Subjects with persistent risks of SRE were significantly characterized by female sex (P < 0.05), psychotic features (P < 0.001), borderline personality disorder (P < 0.01), previous SRE (P < 0.001), and such baseline psychopathology as anhedonia (P < 0.005), irritability (P < 0.005) and hopelessness (P < 0.001). Discriminant analysis showed that baseline severity of SRE, borderline personality disorder and psychotic features were closely associated with SRE during antidepressant therapy. Total scoring using those three pretreatment factors predicted risks of SRE with sufficient sensitivity (81%)/specificity (98%) as well as high positive likelihood ratio (43.9).
Conclusions: These findings suggest that deteriorated risk of SRE in child and adolescent patients receiving antidepressants should not be overestimated while some pretreatment characteristics may be useful to predict the outcome of SRE after antidepressant therapy.