HOSPITALIZING THE SUICIDAL ADOLESCENT - DECISION-MAKING CRITERIA OF PSYCHIATRIC-RESIDENTS

Objective: The primary purpose of this research is to investigate the criteria used by general psychiatric residents in determining the appr opriateness of hospitalization. Method: A questionnaire containing 64 vignettes describing adolescent suicide attempts was completed by a sa mple of 33 residents from a general psychiatry training program. Six v ariables known to relate to lethality of attempt were systematically v aried within the vignettes: gender, depression, conduct disorder/subst ance abuse, previous attempts, suicidal relative, and family supports. Respondents were asked to judge the appropriateness of hospitalizatio n for each vignette. Results: Hospitalization preference was significa ntly predicted by all risk factors except for gender, with the presenc e of depression emerging as the most important predictor of hospitaliz ation. Residents recommended hospitalization more frequently than did experienced child and adolescent clinicians. In comparison with experi enced clinicians, residents placed more importance on depression, and less importance on conduct disorder/substance abuse, in making decisio ns to hospitalize. Conclusions: Although psychiatric residents use kno wn risk factors for adolescent suicide in assessing need for hospitali zation, there was clear support for further training initiatives for p sychiatric residents concerning the assessment of suicidal adolescents .