New Australian research has found that young people who report suicidal thoughts and who also experience auditory hallucinations and psychological distress are at the greatest risk of future suicide attempts.
The study by researchers from QIMR Berghofer and The University of Queensland’s Centre for Clinical Research examined risk factors that prompted 12 to 17 year olds to transition from thinking about hurting themselves to acting on those thoughts.
Psychological distress can be characterised by a number of symptoms including stress, anxiety, low mood, loss of sleep due to worry, or feelings of being constantly under strain. It is usually assessed by a questionnaire.
Hallucinations can include hearing voices when no one else is present, or hearing voices that other people cannot hear.
Primary researcher and PhD candidate Emily Hielscher, from QIMR Berghofer’s Child and Youth Mental Health Research Group, said the study gathered psychological, social, and behavioural data from more than 1600 Australian high school students.
“Of those adolescents, 216 reported experiencing suicidal thoughts at the start of the study, and they were interviewed 12 months after that time to see who actually went on to attempt suicide,” Ms Hielscher said.
“We found that within the group with suicidal thoughts, those who said they also experienced auditory hallucinations and were distressed were nine times more likely to attempt suicide, compared to study participants with suicidal thoughts who reported no hallucinations or little to no psychological distress.
“The adolescents who had suicidal thoughts and reported being distressed, irrespective of their experiences of hallucinations, were four times more likely to attempt suicide compared to those with low levels of distress.
“Interestingly, we found that adolescents who said they’d been diagnosed with depression and had experienced stressful life events, such as bullying, were not at significantly increased risk of suicide attempts.
“These findings support other studies which show such factors as depression and impulsivity are not good at predicting who will go on to transition from suicidal thoughts to attempts.”
Senior author and the head of QIMR Berghofer’s Mental Health Program, Associate Professor James Scott, said the study provided a valuable insight into the serious and far reaching public health issue.
“Suicide is the leading cause of death in 15 to 24 year olds, with between two and three per cent of all Australian adolescents attempting suicide every year, so research in this area is very important,” Associate Professor Scott said.
“A key challenge is that suicidal thinking in adolescents is common. Identifying the risk factors that are associated with the transition of adolescents from thinking of suicide to acting on those thoughts is critical for keeping young people safe.
“There appears to be something about adolescents experiencing hallucinations which elevates their risk of suicide, on top of the effect of being distressed.
“Knowing a person is at risk provides the chance for early intervention and help.”
Associate Professor Scott, who is also a child and adolescent psychiatrist, said one in 12 adolescents report having hallucinatory experiences.
“The role of hallucinations and distress in the transition from suicidal thoughts to attempts has not been identified before, so these findings advance our understanding of adolescent suicide and mental health,” Associate Professor Scott said.
“We’ll continue to analyse the information these young people have provided us to learn more about relevant predictors of this critical transition period from suicidal thoughts to attempts. Hopefully that can help us develop better screening procedures for young people at risk.
“The findings also highlight the need to start a conversation about mental health screening of young people and more training for GPs in identifying the risk factors.”
The study looked at data collected through self-reported questionnaires conducted at 12-month intervals from 2010 to 2012. Participants were offered support and those who were identified as being at risk of suicide were referred to the appropriate support service. The study was approved by a Human Research Ethics Committee.
The research findings have been published in the international journal Acta Psychiatrica Scandinavica.
The research was supported by an Australian Research Council Discovery Grant, the National Health and Medical Research Council and by the Dr F and Mrs ME Zaccari Scholarship, Australia.
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