Suicidal Ideation in Youth with Depression
Hughes, Jennifer Lynn
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Suicide is the third leading cause of death in youth ages10 to 24 (Centers for Disease Control, 2007). Frequent thoughts of suicide are a strong predictor of suicide attempt (Kienhorst, de Wilde, Van den Bout, Diekstra, & Wolters, 1990), and most suicide attempters report a history of suicidal ideation (Lewinsohn, Rohde, & Seeley, 1996). Although suicidal ideation does not always intensify into suicidal behavior, a better understanding of suicidal ideation may lead to a greater understanding of suicidal behavior (Reuter, Holm, McGeorge, & Conger, 2008). It has been suggested that suicidality can be conceptualized as a spectrum, ranging from passive thoughts of death to death by suicide (Bridge, Goldstein, & Brent, 2006). Mood disorders, including MDD, are the most common in suicide attempters and those who die by suicide (Bridge et al., 2006; Kelly, Cornelius, & Lynch, 2002; Weissman et al., 1999), and hopelessness has consistently been implicated as being related to attempted suicide and death by suicide (Goldston et al., 2001; Lewinsohn, Rohde, & Seeley, 1994; Shaffer et al., 1996). As up to 85% of adolescents with major depressive disorder (MDD) or dysthymia report experiencing suicidal ideation (Kovacs, Goldston, & Gatsonis, 1993), the co-occurrence of depression and suicidal ideation is high. Therefore, it is important that interventions for depressed youth include strategies to manage suicidal ideation and behavior. In addition, it is important for clinicians to have an awareness of how higher levels of suicidal ideation might affect treatment in depressed youth. Thus, a better understanding of the course of suicidal ideation and behavior during early treatment and a better understanding of how depression treatment affect suicidality have important public health implications.