PTSD Following Suicide Attempts in Adolescents: a Case Series

The Diagnostic and Statistical Manual (DSM) does not specifically identify one's own suicide attempt as a potential source of trauma for the development of posttraumatic stress disorder (PTSD). PTSD following a near death experience in an adolescent may occur in both the adolescent and the parent. However, suicide-attempt-related PTSD (SA-PTSD) is scarce in the literature, particularly in the pediatric population. The authors review three cases of adolescent patients or their parents in an outpatient clinical practice who displayed varying severity of SA-PTSD symptoms. Information was obtained via self-report by adolescent, parent, or both. Screening for SA-PTSD symptoms was not explicitly sought; rather patients or parents volunteered such information de novo during clinical encounters which was then explored further. One adolescent had only brief PTSD-like experiences that faded with time and did not require intervention. A second adolescent reported long-term memory loss around the circumstances of their suicide attempt that may be related to medical morbidity; their parent had significant PTSD symptoms throughout treatment, and the parent was referred to their own therapy. A third adolescent was referred for cognitive-behavioral therapy (CBT) for the treatment of pervasive PTSD symptoms from a previous suicide attempt, with symptoms improving after treatment. A qualititative analysis suggests that more severe SA-PTSD symptoms are associated with 1) multiple prior suicide attempts; 2) more severe/higher morbidity suicide attempt; and 2) previous diagnosis of PTSD in patient or parent. Assessment for SA-PTSD is important to ensure that affected patients and their families are referred for appropriate resources and treatment. Of the very small sample of three cases, two required specific referral to treat PTSD symptoms in either the adolescent or the parent. The literature about SA-PTSD is extremely scarce. Only two studies systematically examined PTSD following suicide attempt, and none of these studies were in pediatric patients, making more robust quantitative or qualitative analysis limited at this time. Therefore, more research regarding epidemiology, risk factors, and treatment is needed.