O13.8. TEEN PSYCHOSIS AND SUICIDE

Abstract

Background: The risk for self-harm in teenagers experiencing psychotic symptoms has been and is an urgent clinical matter, as adolescents in this population are at much greater risk for suicide compared to the same age group in the general population. Researchers have called for investigations into clinical markers specific to psychosis and this age group in hopes of developing therapeutic targets to mitigate suicide risk. Method(s): We examined the prevalence of suicidality and predictors associated with suicidal ideation and attempts in 101 adolescents ages 12 to 18 enrolled in intensive day treatment for youth diagnosed with psychotic spectrum disorders. Result(s): Similar to other studies in this young population, about half reported mild to moderate suicidal ideation at intake, with 43% reporting a past lifetime attempt. Teenagers at clinical high risk for psychosis (CHR; n=58) who endorsed delusions were 5 times more likely to endorse suicidal ideation odds ratio ([OR]=5.22; 95% CI, 3.27-9.81; p<0.01), while those with obsessive-compulsive symptoms were almost 4 times more likely to do so (OR=4.06; p<0.01). Teenagers who endorsed "not true" on item 6 of the Maryland Assessment of Recovery Scale ("I feel accepted as who I am") were 12 times more likely to report suicidal ideation. Notably, teenagers who endorsed all three items-delusions, OCD symptoms, and not feeling accepted by others-were 31 times more likely to endorse SI and report at least one past suicide attempt (OR=30.98; 95% CI, 27.11-33.09; p<0.001). Similar risks were found in adolescents with psychosis (AWP; n=43), with those reporting OCD symptoms and not feeling accepted 15 times more likely to be at risk (OR=15.33; 95% CI, 13.04-16.27; p<0.01). When examining those who had made a recent attempt (n=31 or 30%), risk factors included overvalued beliefs (SIPS first rank symptoms), aggressive obsessions (Y-BOC), and cognitive inflexibility (PCET). Discussion(s): Delusions, OCD symptoms, cognitive inflexibility, and perceptions of identity were robust predictors of suicide risk and attempts in teenagers with psychosis.