To investigate the prevalence of suicidal behaviors and their associated risk factors among adolescent inpatients with depression.

A retrospective analysis of the medical records of 442 adolescent inpatients diagnosed with depression at Shenzhen Kangning Hospital from January 2016 to December 2022 was conducted. Among them, 64 were male and 358 were female. They range in age from 10 to 17. The MINI suicidal module assessment on the day of admission was employed. Based on the presence or absence of suicidal behavior in the past month, patients were divided into the attempted suicide group (n=140) and the non-attempted suicide group (n=302). Comparative analysis was performed on the sociodemographic characteristics, clinical features, endocrinological indices, and scores from the Eysenck Personality Questionnaire (EPQ), Short Form of the Family Environment Scale (FES-F), Adolescent Self-Rating Life Events Checklist (ASLEC), Childhood Trauma Questionnaire (CTQ), Multidimensional Anxiety Scale for Children (MASC), and Child Depression Inventory (CDI) between the two groups. Logistic regression was utilized to identify risk factors associated with suicidal behavior.

The prevalence of suicidal behavior in the past month among adolescent inpatients with depression was 31.67% (140/442), and the lifetime prevalence was 53.8% (238/442). Compared to patients in the non-suicidal attempt group, those in the suicidal attempt group showed higher occurrences of psychotic symptoms, comorbid physical diseases, and past suicidal behaviors, respectively, at 46% (64/140) vs 26%(77/302), 34%(47/140) vs 21%(65/302), and 81% (114/140) vs 32%(98/302) (χ²=18.00, 7.34, 91.94; all P<0.05). In terms of scale scores, patients in the suicidal attempt group, compared to those in the non-suicidal attempt group, had higher scores in the health adaptation factor in ASLEC, with[M(Q₁,Q₃)] 6 (4, 9) vs 5(3, 8) (χ²=2.13, P<0.05); higher scores in the somatic symptom factor in MASC, with 26 (19.25, 31) vs 24 (16, 29) (χ²=2.50; P<0.05); and higher scores in the negative emotions, low self-esteem, interpersonal problems factors, and overall CDI score (χ²=2.35; P<0.05). Regression analysis showed that psychotic symptoms (OR=1.85, 95%CI: 1.13-3.02), comorbid physical illnesses (OR=1.85, 95%CI: 1.09-3.14), and past suicidal behaviors (OR=8.34, 95%CI: 5.01-13.88) were risk factors for recent suicidal behavior (all P<0.05).

Among adolescent inpatients with depression, the past-month suicidal behavior and any suicidal behaviors in the past are pretty high. Previous suicidal behavior, presence of psychotic symptoms, and comorbid physical disease could be the risk factors for near-future suicidal behavior.

Depressive disorder; Adolescents; Suicidal behavior; Incidence; Risk factors; Psychotic symptoms; Comorbid somatic diseases