3.14 COMPARISON OF THE GENDER AND DIAGNOSTIC FACTORS IN EXPLAINING SUICIDE IDEATION AMONG YOUTH IN CLINICAL TREATMENT

Objectives: It has been observed that adolescent females in clinical treatment exhibit a higher incidence of suicidal ideation and psychiatric disorders than males. The purpose of this study was to test the relative significance of internalizing and externalizing diagnoses and gender in their association with suicidal ideation among youth in tertiary psychiatric care. Methods: Data were collected from 506 youth between the ages of 12 and 18 years who were receiving psychiatric treatment at the Royal Ottawa Mental Health Centre (Ottawa, ON, Canada). Participants in this program generally present with severe and complex early onset major psychiatric disorders. The sample group included both inpatient and outpatient participants. All participants in the youth treatment program completed an array of clinical assessments upon entry into the program. Clinical diagnoses were based on the DSM-IV criteria for axis 1 disorders. In this study, the primary outcome variable was the presence or absence of suicidal ideation as measured with item 9 of the Beck Depression Inventory -- Second Edition. An ordinal regression was used to establish the association between internalizing and externalizing classification and suicidal ideation while controlling for gender. Results: The gender covariate showed a significant relationship to the progression of the course of suicidal ideation (P < 0.001). Female participants were 2.5 times more likely than males to express active suicidal ideation (OR = 0.41). Participants with internalizing disorders were also more likely to present with active suicidal ideation, although the effect was less pronounced than the effect of gender (OR = 0.51). The interaction of gender and diagnostic schema was observed to be nonsignificant. Conclusions: The results indicate that gender is a significant predictor of active suicidal behaviors. These findings suggest that interventions targeting suicidal ideation should acknowledge the influence of gender and target females, irrespective of the presenting diagnosis.