Huttle Alexandra, Rombola Christina, Ortin-Peralta Ana, Abramson Erika L, Waseem Muhammad, Miranda Regina
Department of Pediatrics (A Huttle and EL Abramson), Weill Cornell Medicine, Cornell University and New York-Presbyterian Hospital, New York, NY.
Department of Psychology (C Rombola and R Miranda), Hunter College of the City University of New York, New York, NY.
Acad Pediatr. 2025 May-Jun;25(4):102795. doi: 10.1016/j.acap.2025.102795. Epub 2025 Feb 7.
Pediatricians are uniquely positioned to identify suicide-related risk, yet clinical practices as to when, how, and who gets screened may vary due to differences in policy statements on youth suicide risk screening in primary care. To address these differences, we examined agreement between reports of past suicide ideation (SI) and suicide attempt (SA) across multiple assessment methods and over time. We further explored associations across sociodemographic factors and severity of mental health symptoms on reporting patterns on these methods for adolescents at elevated risk.
Adolescents (N = 162) with SI and/or SA were recruited from multiple clinical sites in and around New York City. Adolescents completed interviews and self-report measures validated to assess suicide-related risk, depressive symptoms, and anxiety symptoms.
Agreement between questions on verbal interviews over time was fair (κ = 0.38), with adolescents under-reporting lifetime SI as time from a crisis went by. Agreement between questions on self-report measures was moderate (κ = 0.51), with adolescents under-reporting past-month SI on a depression screen compared to a suicide-specific screen. Participants with less severe mental health-related symptoms were significantly less likely to report past-month SI consistently.
This study highlights important trends in suicide-related reporting patterns among adolescents at elevated risk for suicide and may have important implications for clinical practice guidelines. To capture more adolescents at risk for suicide, results not only support a universal screening approach using suicide-specific tools but may suggest the need to increase screening frequency in pediatric primary care.
儿科医生在识别自杀相关风险方面具有独特地位，但由于初级保健中青少年自杀风险筛查政策声明的差异，关于何时、如何以及对谁进行筛查的临床实践可能会有所不同。为了解决这些差异，我们研究了多种评估方法以及不同时间点过去自杀意念（SI）和自杀未遂（SA）报告之间的一致性。我们还进一步探讨了社会人口学因素与心理健康症状严重程度之间的关联，这些因素与高风险青少年在这些方法上的报告模式有关。
从纽约市及其周边的多个临床地点招募有自杀意念和/或自杀未遂的青少年（N = 162）。青少年完成了经过验证的访谈和自我报告测量，以评估自杀相关风险、抑郁症状和焦虑症状。
随着时间推移，口头访谈问题之间的一致性一般（κ = 0.38），随着危机过去的时间增加，青少年对终生自杀意念的报告有所少报。自我报告测量问题之间的一致性中等（κ = 0.51），与特定自杀筛查相比，青少年在抑郁筛查中少报过去一个月的自杀意念。心理健康相关症状较轻的参与者持续报告过去一个月自杀意念的可能性显著较低。
本研究突出了自杀高风险青少年自杀相关报告模式的重要趋势，可能对临床实践指南具有重要意义。为了发现更多有自杀风险的青少年，结果不仅支持使用特定自杀工具的普遍筛查方法，还可能表明需要增加儿科初级保健中的筛查频率。
