Suicidal Behaviours and Depression in Adolescents in an Outpatient Department of a Tertiary Care Hospital in Lahore, Pakistan

Background : Adolescents’ changing emotional, physical, and psychological needs make them vulnerable to different psychiatric illnesses, including suicidal behaviors. Objectives : To assess the prevalence and gender differences of suicidal behaviours, depression, the role of previous suicidal attempts and depression severity in predicting suicidal behaviours among adolescents presenting to a tertiary care hospital in Pakistan. Methods: Following ethical approval and informed consent, 300 adolescents aged 10–18 years presenting to Child and Family Psychiatry Outpatient Department, King Edward Medical University, Lahore, Pakistan were interviewed. Suicidal behaviors and Depression were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS)-Suicidality items and the Beck Depression Inventory (BDI), respectively. Data was analyzed using SPSS. Results: 300 adolescents (53% females with a mean age of 14.11(SD=2.54) years were recruited. Overall, 13% (n=40) of the adolescents displayed suicidal behaviors. Among these, 5% (15) had suicidal ideations, 5.3% (16) reported suicidal attempts and 3% (9) were engaged in non-suicidal self-injury (NSSI). There were no significant gender differences in the type of suicidality, although suicidal behaviors were more prevalent in girls. About 56% of adolescents (168) had moderate to severe or severe depression according to BDI. Girls had significantly higher mean depression scores than boys (p <.001). The severity of depressive symptoms differed significantly between suicidal behavior groups (p <.001). Adolescents with attempted suicide had significantly higher levels of depression than those with no suicidal behaviors. History of past suicidal behaviors significantly predicted suicidal ideation and attempts, while moderate to severe depression significantly predicted NSSI but not suicidal ideation or attempts. Conclusion: This study demonstrates significant suicidal behaviors and depression among adolescents presenting to psychiatric settings in Pakistan. Assessment and management of depression and suicidality, and adequate treatment, is important to reduce the burden of psychiatric problems and suicide risk in this vulnerable population.