Suicidal behaviors and their relationship with psychotic-like symptoms in children and adolescents at clinical high risk for psychosis

Eugene J D'Angelo; Sarah Hope Lincoln; Nicholas Morelli; Kelsey Graber; Sahil Tembulkar; Joseph Gonzalez-Heydrich

doi:10.1016/j.comppsych.2017.07.008

Suicidal behaviors and their relationship with psychotic-like symptoms in children and adolescents at clinical high risk for psychosis

Compr Psychiatry. 2017 Oct:78:31-37. doi: 10.1016/j.comppsych.2017.07.008. Epub 2017 Jul 20.

Authors

Eugene J D'Angelo¹, Sarah Hope Lincoln², Nicholas Morelli³, Kelsey Graber⁴, Sahil Tembulkar⁵, Joseph Gonzalez-Heydrich⁶

Affiliations

¹ Boston Children's Hospital, Department of Psychiatry, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: eugene.dangelo@childrens.harvard.edu.
² Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; McLean Hospital, Department of Psychiatry, 115 Mill Street, Belmont, MA 02478, USA. Electronic address: slincoln@fas.harvard.edu.
³ Boston Children's Hospital, Department of Psychiatry, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address: nicholas.morelli@childrens.harvard.edu.
⁴ Boston Children's Hospital, Department of Psychiatry, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address: kelsey.graber@childrens.harvard.edu.
⁵ Boston Children's Hospital, Department of Psychiatry, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address: sahil.tembulkar@childrens.harvard.edu.
⁶ Boston Children's Hospital, Department of Psychiatry, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: joseph.gonzalez-heydrich@childrens.harvard.edu.

PMID: 28803039
DOI: 10.1016/j.comppsych.2017.07.008

Abstract

Background: Previous research has demonstrated elevated rates of suicide attempts and ideation in individuals with psychosis. This study investigated rates and severity of suicidal behavior in youth with and at clinical high risk for psychosis, and examined the positive, negative, and disorganized symptoms associated with suicidal behaviors among the clinical high risk group.

Methods: Eighty-six youth ages 7-18 (n=21 non-clinical controls [NCC], n=40 clinical high risk [CHR], n=25 diagnosed psychotic disorder [PD]) were recruited. CHR and PD participants were identified using the Structured Interview for Prodromal Symptoms (SIPS) and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL). All participants completed the Suicide Behaviors Questionnaire-Revised (SBQ-R).

Results: Findings indicated significantly higher levels of suicidal behavior among CHR and PD relative to NCC participants (F=7.64, p=0.001). 17.5% of CHR participants had previously attempted suicide. Dysphoric Mood and Odd Behavior or Appearance were significantly correlated with suicidal behavior severity among CHR youth.

Conclusion: Suicidal behavior was observed with greater frequency and severity in the CHR and PD groups than in the NCC group. CHR suicidal behavior severity was correlated most strongly with Dysphoric Mood and Odd Behavior or Appearance, a relationship which warrants further investigation.

MeSH terms

Adolescent
Child
Female
Humans
Male
Prodromal Symptoms*
Psychotic Disorders / psychology*
Suicidal Ideation*
Suicide, Attempted / psychology*