PSYCHIATRIC DIAGNOSES OF PREVIOUS SUICIDE ATTEMPTERS, FIRST-TIME ATTEMPTERS, AND REPEAT ATTEMPTERS ON AN ADOLESCENT INPATIENT PSYCHIATRY UNIT

Objective: To compare psychiatric diagnoses of hospitalized adolescent s who (a) have made previous but no recent suicide attempts, (b) have recently made their first suicide attempt, (c) have recently made a se cond or subsequent attempt, or (d) have never made an attempt. Method: Semistructured psychiatric diagnostic interviews were used to determi ne psychiatric diagnoses and history of recent and previous suicidal b ehavior of 269 consecutively admitted adolescents to an inpatient psyc hiatric facility. Forty-nine previously suicidal youths, 28 first-time attempters, and 33 repeat attempters were compared with 159 nonsuicid al youths in prevalence of Axis I psychiatric disorders and psychiatri c comorbidity with affective disorder. Results: Previous attempters an d repeat attempters both reported more affective disorders, whereas fi rst-time attempters reported more adjustment disorders than nonsuicida l youths. Previous attempters and nonsuicidal youths reported the most externalizing disorders. Conclusions: Previous attempters on an inpat ient unit have multiple psychiatric problems. Like repeat attempters, they often are depressed, but like nonsuicidal youths, they also exhib it significant externalizing behaviors. Interventions with these adole scents should focus not only on immediate presenting problems, but als o on ameliorating their long-term risk of posthospitalization suicidal behavior.