Suicidal ideation, suicidal attempts and non-suicidal self-injuries in referred adolescents

Background. Specific risk factors may affect persistent suicidal ideation (SI) and suicide attempts (SA) in adolescence. Nonsuicidal self-injuries (NSSIs) are possible antecedent or associated factors of suicidality. Aims. To compare clinical features in adolescents with mood disorders referred for severe SI and for SA, and to explore differences in those with or without NSSIs. Method. 22 youth with severe SI (16 mates [773%], mean age 14.86 +/- 1.86 years), and 19 with SA (16 males [84.2%], mean age 15.05 +/- 1.75 years) were assessed for familial psychiatric disorders/suicidal attempts, traumatic antecedents, diagnosis, impulsivity, hopelessness, attitude for life and death, resilience, and according to additional NSSIs. Results. Patients with SI presented more frequent anxiety disorders, those with SA more severe suicidal ideation with plan and intention, and more duration of suicidal ideation. Resilience was lower in SI, while all the other features did not distinguish the two groups. NSSIs were found in 70.7% of the sample, without differences between groups; only impulsivity was more frequent in NSSI group. Discussion. These specific features were frequently found in this high-risk sample. but only comorbid anxiety disorders, and more active, persistent and planned suicidal ideation differentiated the two groups. Conclusions. Patients with severe SI and SA may represent different variants of the same clinical entity. Given the high frequency of the explored features in the whole suicidal sample, this diagnostic methodology may be helpful and informative in all the high-risk adolescents with mood disorders, namely with NSSI.