Suicide attempts among formerly hospitalized adolescents: A prospective naturalistic study of risk during the first 5 years after discharge

Objective: To examine risk for suicide attempts among 180 consecutively ref erred adolescents during the first 5 years after discharge from an inpatien t psychiatry unit Method: In a prospective naturalistic study, adolescents were assessed at psychiatric hospitalization and semiannually thereafter fo r up to 5 years with semistructured psychiatric diagnostic interviews and s elf-report questionnaires. Results: Approximately 25% of the adolescents at tempted suicide and no adolescents completed suicide within the first 5 yea rs after discharge. The first 6 months to 1 year after discharge represente d the period of highest risk. The number of prior attempts was the stronges t predictor of posthospitalization attempts. Affective disorders by themsel ves did not predict later suicide attempts but were related to posthospital ization attempts when accompanied by a history of past suicide attempts. In dependent of psychiatric diagnoses, severity of depressive symptoms and tra it anxiety also predicted suicide attempts. Similar to the effect with affe ctive disorders, depressive symptoms were most strongly related to posthosp italization suicidality among adolescents with a prior history of suicide a ttempts. Conclusions: Particularly among youths with prior suicidal behavio r, clinicians should be alert to the above constellation of psychiatric pre dictors of posthospitalization suicidal behavior.