Adolescents with depressive disorders and non-suicidal self-injury (NSSI) often present with suicidal thoughts and behaviors in clinical practice. However, data on high-risk suicidality among adolescents receiving routine outpatient psychiatric care remain limited. We examined the prevalence of suicidality indicators and correlates of high-risk suicidality among depressed adolescent outpatients with NSSI. This cross-sectional study recruited adolescents aged 12–17 years from the psychiatric outpatient clinic of Liuzhou Workers’ Hospital. Depressive disorders were diagnosed according to DSM-5 criteria, and NSSI was defined using the proposed DSM-5 criteria. Suicidality was assessed using the suicidality module of the Mini-International Neuropsychiatric Interview (MINI), Chinese version, Version 5.0. High-risk suicidality was defined as endorsement of a past-month suicide plan and/or a past-month suicide attempt. Depressive and anxiety symptoms were assessed using the 13-item Beck Depression Inventory (BDI-13) and Beck Anxiety Inventory (BAI). Insomnia symptoms were assessed using an 8-item Sleep Disturbance Questionnaire (SDQ-8); an insomnia symptom score was calculated by summing three core insomnia symptom items (difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening), which reflect core DSM-5 insomnia symptoms. We performed group comparisons and multivariable logistic regression adjusting for age, sex, and sleep score. Depressive and anxiety symptoms were modeled separately due to collinearity. A total of 100 adolescents were included (mean age 14.82 ± 1.31 years; 90% female). Past-month endorsement rates were high for wishing to be dead (93.0%), desire to harm oneself (95.0%), and suicidal thoughts (96.0%). Past-month suicide plan was reported by 57.0% and past-month suicide attempt by 30.0%. Overall, 61.0% met criteria for high-risk suicidality. Compared with those without high-risk suicidality, affected adolescents had higher sleep scores (7.52 ± 1.40 vs. 6.92 ± 1.55; p = 0.047) and more severe depressive and anxiety symptoms (BDI: 25.25 ± 6.94 vs. 20.38 ± 6.77; p < 0.001; BAI: 31.79 ± 12.59 vs. 23.69 ± 9.42; p < 0.001). In adjusted models, higher BDI (OR = 1.098, 95% CI 1.016–1.186; p = 0.018) and higher BAI (OR = 1.066, 95% CI 1.014–1.120; p = 0.012) were independently associated with high-risk suicidality. High-risk suicidality was highly prevalent (61.0%) among depressed adolescent outpatients with NSSI. Greater depressive and anxiety symptom severity were independently associated with high-risk suicidality, supporting the importance of routine suicidality screening and symptom-informed risk stratification. Not applicable.
Li et al. (Sat,) studied this question.