Profiles of suicidality and clusters of Hungarian adolescent outpatients suffering from suicidal behaviour.

BACKGROUND: The aim of the study was to reveal the background dimensions of suicidal behaviour (SB) and to identify clusters of Hungarian adolescent outpatients suffering from suicidality by means of the following correlates of SB: depression, inadequate conflict-solving methods, dysfunctional attitudes, maladaptive coping, help-seeking strategies and negative life events. SAMPLING AND METHODS: A self-report test battery was completed by every consecutive new adolescent outpatient from a representative patient pool of 5 local child psychiatric centres in Western Hungary over an 18-month period (n = 644). The questionnaires used were the pilot version of the Columbia Depression Scale, the Hungarian standard versions of the Beck Depression Inventory, the Ways of Coping Questionnaire, the Dysfunctional Attitude Scale and the Junior High Life Experiences Survey. A total of 110 adolescent outpatients (88 females, 22 males, mean age = 16.21 years, SD = 1.38) suffering from SB were included in the study. All diagnoses including SB were confirmed by the MINI Plus Mini International Neuropsychiatric Interview. K means clustering was used to compare variances of 19 variables to decide which ones are the major criteria for assigning subjects to clusters, and principal component analysis was utilized to identify background SB dimensions in the patient sample. RESULTS: The cluster analysis identified 3 homogenous clusters differentiating suicidal adolescents characteristically: 'stress-laden/medium depressive', 'low depressive/low achievement' and 'high depressive' cluster groups. While cluster analysis confirmed the role of the severity of depression only, principal component analysis explored the following 4 underlying profiles of SB: stress-laden, dysfunctional, maladaptive and depressive/risky factors. CONCLUSIONS: Although important coping qualities failed to register as major criteria in the development of separate groups of suicidal adolescent outpatients, distinct background profiles of SB among Hungarian adolescents were found covering the risk groups according to clinical experience. Future research is warranted to identify possible variation in the coping strategies among different adolescent suicidal samples.

[Maladaptive strategies, dysfunctional attitudes and negative life events among adolescents treated for the diagnosis of "suicidal behaviour"]. / Maladaptív stratégiák, diszfunkcionális attitudök, megküzdés és negatív életesemények, "öngyilkos magatartás" diagnózissal kezelt serdülo betegeknél.

OBJECTIVE: To identify underlying factors and subgroups (depression and substance abuse, their school and behavioural consequences, suicide spectrum (ideas + attempts + attitudes), inadequate problem-solving methods, dysfunctional attitudes, maladaptive coping and help-seeking strategies and negative life events) for suicidality in Hungarian adolescent outpatients suffering from "suicidal behaviour". METHOD: A multidimensional self-report test battery - consisting of the Columbia Depression Scale (CDS), including the BDI and the Drug Use Screening Inventory /DUSI/, and of the Hungarian versions of the Ways of Coping questionnaire, of the Dysfunctional Attitude Scale, and of the Junior High Life Experience?? Survey - was completed by every new adolescent outpatient from a representative patient pool of five local Child Psychiatric Centres of the Western-Hungarian region over an 18-month period (n=596). 99 adolescent outpatients (78 females, 21 males, mean age 16.2 years, SD 1.18) with clinical diagnosis of suicidal behaviour confirmed by the Hungarian version of M.I.N.I. Plus Psychiatric Diagnostic Interview were included in the study. RESULTS: A four-factor solution of the principal component analysis was constructed to explore the underlying dimensions for suicidality labelled as follows: 1. Stress-laden/Risk-taking, 2. Depressed/Dysfunctional, 3. Addictive/Risk-taking and 4. Suicidal/Maladaptive factors. DISCUSSION: The robust and isolated representation of suicidal ideas+attempts associated with maladaptive coping strategies and with younger age confirms not only the specificity of coping qualities collected by CDS but also the risk position of younger adolescent generation in the most serious subgroups of suicidal population. Our study confirms the association of depression with dysfunctional attitudes and with maladaptive coping distinctly, but risky problem solving, maladaptive coping and dysfunctional attitudes seem to characterize different groups of depressive syndromes with only a moderate overlap. The demarcated factoring of the "Risky" conflict-solving technique of the Ways of Coping Questionnaire from the coping factor of the Columbia test proves that both presumably measure different dimensions of coping. Authors present and explain the PCA results in detail.