The Association Between Suicide Attempts, Anxiety, and Childhood Maltreatment Among Adolescents and Young Adults With First Depressive Episodes.

Chenyuli Luo,Peiqu Liu,Huijuan Guo,Shaoling Zhong,Wen Li,Jiali Liu,Hui Chen,Jiansong Zhou,Xia Cao,Xiaoping Wang,Xiaoxi Liang,Xianliang Chen

doi:10.3389/fpsyt.2021.745470

Abstract

Objective: Adolescents and young adults are susceptible to high-risk behaviors such as self-harm and suicide. However, the impact of childhood maltreatment on suicide attempts in adolescents and young adults with first episode of depression remains unclear. This study examined the association between suicide attempts and childhood maltreatment among adolescents and young adults with first depressive episodes.Methods: A total of 181 adolescents and young adults with first depressive episodes were included. The Child Trauma Questionnaire (CTQ), Beck Anxiety Inventory (BAI), and Patient Health Questionnaire-2 (PHQ-2) were used to assess childhood maltreatment and the severity of anxiety and depressive symptoms, respectively. The suicide item in the MINI-International Neuropsychiatric Interview (M.I.N.I.) 5.0 was used to assess the suicide attempts. Logistic regression analyses were used to explore the associated factors of suicide attempts.Results: The prevalence of SA in the total sample was 31.5% (95% CI = 24.9–38.1%). Multivariate logistic regression analyses revealed that the diagnosis of bipolar disorder (OR = 2.18, 95% CI = 1.07–4.40), smoking (OR = 2.64, 95% CI = 1.10–6.37), anxiety symptoms (OR = 1.05, 95% CI = 1.02–1.08), and childhood maltreatment (OR = 1.04, 95% CI = 1.01–1.07) were potential associated factors of SA. In addition, anxiety symptoms had a mediating effect on the relationship between childhood maltreatment and SA.Conclusion: Adolescents and young adults with first depressive episodes and having experiences of childhood maltreatment are at a high risk of suicide. The severity of anxiety symptoms may mediate the relation between childhood maltreatment and suicide attempts in this group of patients.

Highlights

Suicide attempt (SA), one of the major suicidal behaviors, is defined as an act of self-injuring with the intention of ending one’s own life [1]
A total of 115 (63.5%) patients were diagnosed with major depressive disorder (MDD), while the remaining 66 (36.5%) patients were diagnosed with bipolar disorder (BP)
This study found that 31.5% of treatment-naïve adolescents and young adults with first depressive episodes had SA, which was higher than one previous study about the first-episode and drug naïve patients with MDD with a prevalence of 19.9% [42]

Summary

Introduction

Suicide attempt (SA), one of the major suicidal behaviors, is defined as an act of self-injuring with the intention of ending one’s own life [1]. Suicide is a leading cause of death among young people aged 15–24 years and suicide attempts are considerably high among children and adolescents aged 12–17 years [2, 3]. The prevalence of SA among Chinese adolescents ranges from 0.94 to 9.01%, with an overall prevalence of 2.94% (95% CI = 2.53– 3.41%) [4]. Mental disorders, such as major depressive disorder (MDD) and bipolar disorder (BP), could increase the risk of suicide behaviors in adolescents and young adults [5,6,7]. For patients with BP, suicide behaviors were predominantly present during depressive episodes [13], especially during the first depressive episode [14]

Methods

Results

Discussion

Conclusion