Family conflict, drug or alcohol use and pre-existing suicidal
thoughts were the strongest predictors of suicidal events among adolescents whose depression treatment
was changed after a lack of response to a previous medication.
The findings were reported today in the article "Predictors of Spontaneous and Systematically Assessed
Suicidal Adverse Events in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA)
Study," at AJP in Advance, the online advance edition of The American Journal of Psychiatry (AJP), the
official journal of the American Psychiatric Association.
In the study, 334 adolescent patients who had not responded to a selective serotonin reuptake inhibitor
(SSRI) were switched to a different SSRI or to venlafaxine, with or without cognitive-behavioral therapy.
Forty-eight patients experienced a suicidal event-suicidal ideation (new or worsening), a suicidal threat
or a suicide attempt. The median time from a suicidal threat to a suicidal event was three weeks.
In the AJP article, lead author David Brent, M.D., and colleagues recommend careful monitoring of more
severely depressed adolescent patients who have high levels of suicidal thoughts or family conflict.
Treatments that target family conflict and emotion regulation early may help reduce suicidal events.
Likewise, since the predictors of suicidal events also predict poor treatment response, targeting family
conflict, suicidal ideation and drug use may hasten response and help to reduce the incidence of these
events.
TORDIA is sponsored by the National Institute of Mental Health. Any other funding the authors may
have received is disclosed in the article itself.
The American Journal of Psychiatry is the official journal of the American Psychiatric Association. Statements in this press
release or the articles in the Journal are not official policy statements of the American Psychiatric Association.
About the American Psychiatric Association
The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members
specialize in diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA
at psych and HealthyMinds.
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