Study looks at teens who deny suicidal thoughts, but later die by suicide

Nearly 1 in 3 teens with depression who deny having thoughts of suicide or self-harm on a commonly used mental health screening questionnaire go on to kill or harm themselves in the following months, a new analysis suggests., published in JAMA Psychiatry, looked at 13-to-17-year-olds with depression diagnoses who answered Question 9 of the Personal Health Questionnaire , which is used to screen for depression severity, before intentionally harming or killing themselves between 2009 and 2017.

The researchers split the teens into two groups: a cohort of 691 who completed the questionnaire within 30 days before self-harm or suicide, and another 1,024 who completed the questionnaire within 90 days of self-harm or suicide. In the 30-day cohort, adolescents who gave themselves a score of 0 on the question about thoughts of suicide and self-harm were “significantly” less likely to have depression than those who said they were experiencing thoughts of suicide and self-harm. However, those with a history of inpatient mental health treatment were twice as likely to deny such thoughts as those with no history of mental health hospitalization.

Overall, the researchers found, 30 percent of teens screened with the PHQ-9 who later intentionally self-harmed or died by suicide had reported they had no thoughts of suicide or self-harm on the questionnaire within the previous 30 or 90 days. The researchers note that the questionnaire is used to screen for depression, not suicide specifically, and that the questionnaire became more common during the study period, which could account for some of the findings.To better address surging suicides and self-harm among teens, they write, it’s important to figure out why adolescents deny having such thoughts.

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