Family functioning and suicidal behavior in adolescent inpatients with mood disorders.

Abstract

This study was designed to identify family and parental characteristics associated with suicidal behavior (active intent, gesture, attempt) among adolescent inpatients with mood disorders. Subjects were 32 suicidal adolescent inpatients with mood disorders, 32 nonsuicidal adolescent inpatients with mood disorders, and 38 normal comparison adolescents. A group comparison design was used. Adolescent measures were the Family Assessment Device and two semistructured interviews (Hamilton Rating Scale for Depression, Social Adjustment Inventory for Children and Adolescents). Parent measures were the Symptom Checklist-90 and the Social Adjustment Scale-Self Report. Fathers of suicidal adolescents reported more depression and family unit problems than did fathers of nonsuicidal and normal comparison adolescents, even after controlling for adolescents' depression severity. Suicidal adolescents, in turn, reported less active and communicative relationships with fathers. Differences among suicidal and nonsuicidal adolescents' perceptions of general family functioning were not significant after controlling for adolescents' depression severity. Findings highlight the importance of treating the depressed and potentially suicidal adolescent within the family system and attending to the nature and quality of adolescents' relationships with fathers as well as with mothers. Findings also highlight interactions between suicidal adolescents' depression severity and their negative perceptions of family functioning.