Suicidal adolescents after hospitalization: Parent and family impacts on treatment follow-through

Author(s): Hovey, J. D., Brand, E., Wilson, R., Ghaziuddin, N.

Journal/Book: J Amer Acad Child Adolesc Psy. 1997; 36: 351 West Camden St, Baltimore, MD 21201-2436. Williams & Wilkins. 85-93.

Abstract: Objective: To help determine optimal strategies for treating suicidal adolescents, the authors studied family predictors of compliance with recommended psychotropic medication monitoring, individual therapy, and parent guidance/family therapy sessions. Method: Sixty-six hospitalized, suicidal adolescents participated ina comprehensive diagnostic evaluation and depression/suicidality assessment. Family/parental assessment measures were the Family Assessment Device, Social Adjustment Inventory for Children and Adolescents (parent-adolescent subscales), Symptom Checklist-90-Revised, and Social Adjustment Scale-Self Report. Follow-up evaluation, 6 months posthospitalization, consisted of structured telephone interviews assessing treatment follow-through. Results: Compliance with recommended medication follow-up (66.7%) and individual therapy (50.8%) was better than compliance with parent guidance/family therapy (33.3%) sessions. The most dysfunctional families and those with the least involved/affectionate father-adolescent relationships had the poorest follow-through with parent guidance/family therapy. Mothers' depressive and paranoid symptoms were linked with less adolescent individual therapy and family therapy follow-through. Mothers' hostility was associated with less medication follow-up. Conclusions: Follow-through was best for medication and individual therapy. Multiple family/parental predictors of poor follow-through suggest the need for alternative or supplemental treatment strategies.

Note: Article King CA, Univ Michigan, Dept Psychiat, 1500 E Med Ctr Dr, Ann Arbor,MI 48109 USA

Keyword(s): suicide risk; adolescents; treatment compliance; DIAGNOSTIC INTERVIEW SCHEDULE; SOCIAL-ADJUSTMENT; CHILDREN; INPATIENTS; BEHAVIOR

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