RANDOMIZED CONTROLLED TRIAL EVALUATES RISK OF ADOLESCENT SUICIDE SCREENING PROGRAMS

"Our findings can allay concerns about the potential harm of high
school-based suicide screening," state the authors of an article published
in the April 6, 2005, issue of JAMA, The Journal of the American Medical
Association. The authors note that while evidence for the clinical
validity and reliability of school-based screening procedures has recently
emerged, the potential harm of screening for suicide remains unstudied.
The article examines whether asking an adolescent about suicidal ideation
and behavior during a screening program creates immediate or persistent
distress or increases suicidal ideation among high school students
generally or among high-risk students with depression symptoms, substance
use problems, or previous suicide attempts, specifically.

Students from six high schools in the state of New York participating in a
school-based suicide-screening program were assessed between fall 2002 and
spring 2004. Classes within each of the six high schools were randomized
to either an experimental group (N=1,172 students) or a control group
(N=1,170 students). The experimental group received a first screening
survey with a set of questions assessing suicidal ideation and behavior;
the control group received the same first survey but without suicide
questions. Students' transient distress was measured at the beginning and
end of the first survey and again at the beginning of a second survey
administered 2 days after the first. Both groups received the same second
survey, which included suicide questions.

The authors found that
* Experimental and control groups did not differ significantly in their
distress levels immediately after the first survey or 2 days later.
* The experimental group reported no more suicidal ideation after the
survey than the control group.
* Students with depression symptoms reported more distress and suicidal
ideation than other students; however, being exposed to suicide questions
in the first survey did not exacerbate distress or suicidal ideation among
students with depression. On the contrary, among students with depression,
the experimental group had slightly lower distress scores than the control
group.
* Among previous suicide attempters, the experimental group had less
suicidal ideation than the control group.
The authors conclude that "universal screening for mental health problems
and suicide risk should continue to be at the forefront of the national
agenda for youth suicide prevention."


Full reference
Gould MS, Marrocco FA, Kleinman M, et al. 2005. Evaluating iatrogenic risk
of youth suicide screening programs: A randomized controlled trial. JAMA,
The Journal of the American Medical Association 293(13):1635-1643.

Suicide and deliberate self harm in young people
Keith Hawton, Anthony James

Deliberate self harm ranges from behaviours with no suicidal intent (but with the intent to communicate distress or relieve tension) through to suicide. Some 7%-14% of adolescents will self harm at some time in their life, and 20%-45% of older adolescents report having had suicidal thoughts at some time.

BMJ: 2005; 330; pp 891-894

Study: Suicide Query Won't Plant the Idea

CHICAGO (AP) -- Asking teenagers about suicide won't make them more likely to contemplate it, as some parents and school officials fear, a study suggests. In fact, the study found that simply asking troubled students about any suicidal impulses appears to ease their distress and might make some of them less likely to try killing themselves.

For the whole story, click here: http://www.intelihealth.com/IH/ihtIH/WSIHW000/333/8014/414107