Suicide Ideation Subtypes That Predict a Future and Earlier Suicide Attempt Among Adolescents

A major limitation in understanding which forms of adolescent suicide ideation might predict the risk of a future suicide attempt is that current assessments of adolescents presenting to emergency departments do not consider suicide ideation subtype in assessing risk. The current study examined whether adolescent suicide ideation subtypes, assessed via interview, would differentially predict an increased risk of a future suicide attempt over time.

Adolescents (N = 131) (78% female; 84% Hispanic/Latine), ages 12-19, who presented with suicide ideation (n = 85) or a suicide attempt (n = 46) were recruited primarily from an emergency department and outpatient clinics in New York City for a longitudinal study. Adolescents were interviewed and classified into three suicide ideation subtypes (brief, intermittent, and persistent suicide ideation) and followed up to 3 times over 12 months.

A higher proportion of adolescents with persistent suicide ideation made a suicide attempt at follow-up (47%), compared to those with brief ideation (21%), p < .05. A survival analysis suggested that persistent suicide ideation was associated with a significantly greater risk of making a future suicide attempt sooner (HR = 3.64; 95% CI = 1.61-8.24), compared to brief suicide ideation, with a similar trend for intermittent suicide ideation (HR = 2.30; 95% CI = 1.00-5.28).

Adolescents who present for clinical care with persistent or intermittent suicide ideation may warrant more immediate clinical attention to prevent risk of a future suicide attempt.