Plattner Belinda, The Steve S L, Kraemer Helena C, Williams Ryan P, Bauer Susanne M, Kindler Jochen, Feucht Martha, Friedrich Max H, Steiner Hans
Department of Child and Adolescent Neuropsychiatry, Medical University of Vienna, Vienna, Austria.
J Clin Psychiatry. 2007 Oct;68(10):1593-600. doi: 10.4088/jcp.v68n1019.
Delinquent juveniles are at extreme risk for suicide with death rates 4 times higher than in the general population. Whereas psychopathologic risk factors for suicidal behavior in nonforensic adolescent populations are well defined, psychopathologies associated with suicidality in delinquent juveniles are not yet clear. The objective of this study was to determine gender-specific psychopathologic profiles associated with suicidality in detained juveniles.
The Massachusetts Youth Screening Instrument-Second Version, the Youth Self-Report, and the Mini-International Neuropsychiatric Interview for children and adolescents were used to investigate juveniles in an Austrian pre-trial detention facility. The study sample consisted of all juveniles entering the system between March 2003 and January 2005. Of the 370 eligible participants, 319 completed the study (53 girls and 266 boys; age range, 14 to 21 years; mean = 16.67, SD = 1.45 years).
We found significantly higher prevalence rates of both current (p < .01) and lifetime (p < .001) suicidality in girls than in boys. Suicidal boys exhibited more psychopathology and a wider range of psychopathology compared to nonsuicidal boys. For suicidal girls, psychopathologies appeared more circumscribed (all relevant p values < .04). Using signal detection methods, major depressive disorder, attention-deficit/hyperactivity disorder, and social phobia identified boys at highest risk of suicidality, while a diagnosis of posttraumatic stress disorder identified girls at highest risk.
Suicidality levels are high in delinquent adolescents, especially in girls. Psychopathologic risk factors seem to be gender specific in this population. Not only depression, but also psychopathologies that usually do not arouse strong suspicion for an association with suicidal behavior, i.e., social phobia and ADHD in boys and PTSD in girls, might increase suicide risk. Further research in other countries is needed to replicate our results with respect to sociocultural influences.
违法青少年面临极高的自杀风险，其死亡率比普通人群高4倍。虽然非司法青少年人群中自杀行为的精神病理风险因素已得到明确界定，但与违法青少年自杀倾向相关的精神病理学尚不明确。本研究的目的是确定被拘留青少年中与自杀倾向相关的性别特异性精神病理特征。
使用《马萨诸塞州青少年筛查工具第二版》《青少年自我报告》以及针对儿童和青少年的《迷你国际神经精神病学访谈》对奥地利一个审前拘留设施中的青少年进行调查。研究样本包括2003年3月至2005年1月期间进入该系统的所有青少年。在370名符合条件的参与者中，319人完成了研究（53名女孩和266名男孩；年龄范围为14至21岁；平均年龄 = 16.67岁，标准差 = 1.45岁）。
我们发现，女孩当前（p <.01）和终生（p <.001）自杀倾向的患病率均显著高于男孩。与无自杀倾向的男孩相比，有自杀倾向的男孩表现出更多的精神病理学问题，且精神病理学范围更广。对于有自杀倾向的女孩，精神病理学问题似乎更为局限（所有相关p值 <.04）。使用信号检测方法，重度抑郁症、注意力缺陷多动障碍和社交恐惧症确定男孩自杀风险最高，而创伤后应激障碍的诊断确定女孩自杀风险最高。
违法青少年的自杀倾向水平较高，尤其是女孩。在这一人群中，精神病理风险因素似乎具有性别特异性。不仅抑郁症，而且通常不会引发与自杀行为关联强烈怀疑的精神病理学问题，即男孩中的社交恐惧症和注意力缺陷多动障碍以及女孩中的创伤后应激障碍，都可能增加自杀风险。需要在其他国家进行进一步研究，以复制我们关于社会文化影响方面的结果。
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