• Paul Wilkinson, Raphael Kelvin, Chris Roberts, Bernadka Dubicka, and Ian Goodyer.
• Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, England, UK. pow12@cam.ac.uk
• Am J Psychiatry. 2011 May 1; 168 (5): 495-501.

ObjectiveThe authors assessed whether clinical and psychosocial factors in depressed adolescents at baseline predict suicide attempts and nonsuicidal self-injury over 28 weeks of follow-up.MethodParticipants were 164 adolescents with major depressive disorder taking part in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Clinical symptoms, family function, quality of current personal friendships, and suicidal and nonsuicidal self-harm were assessed at baseline. Suicidal and nonsuicidal self-harm thoughts and behaviors were assessed during 28 weeks of follow-up.ResultsHigh suicidality, nonsuicidal self-injury, and poor family function at entry were significant independent predictors of suicide attempts over the 28 weeks of follow-up. Nonsuicidal self-injury over the follow-up period was independently predicted by nonsuicidal self-injury, hopelessness, anxiety disorder, and being younger and female at entry.ConclusionsBoth suicidal and nonsuicidal self-harm persisted in depressed adolescents receiving treatment in the ADAPT study. A history of nonsuicidal self-injury prior to treatment is a clinical marker for subsequent suicide attempts and should be as carefully assessed in depressed youths as current suicidal intent and behavior.

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