Psychopathological profiles of adolescent presenting to emergency departments following a suicide attempt: A comprehensive analysis

Abstract

Background. Despite the identification of several risk factors, an understanding of the role of specific psychopathological profiles in association with adolescent suicidal behaviours remains a key challenge in public health research. The study aimed to identify psychopathological profiles in suicidal adolescents and to analyse their association with suicide-related outcomes. Methods. A total of 285 adolescents aged 12 to 17 years [mean age (SD)=14.98 (1.51); females: 249 (87.40%)] who had attempted suicide within the past 10 days were recruited from different Spanish hospitals. Clinical assessments included psychiatric diagnoses, depressive symptoms, trauma, impulsivity, and suicidal thoughts and behaviours. Latent profile analysis was performed to classify subgroups with similar patterns based on self-report Strengths and Difficulties Questionnaire. Logistic regression and generalised linear modelling were applied to examine the relationship between profile membership and suicidal behaviours. Results. Three psychopathological profiles were identified: internalizing symptom profile (52.63%), externalizing symptom profile (24.21%), and low symptom profile (25.58%). The predominantly female internalizing symptom profile members were more likely to report higher levels of psychopathological symptoms, including number of psychiatric diagnoses, depressive symptoms, and trauma (except sexual abuse). Additionally, they had more non-suicidal self-injury and suicidal thoughts and behaviours. Likewise, greater ideation intensity was associated with the internalizing symptom profile compared to other groups, while greater number of previous suicide attempts correlated with an increase in suicidal behaviours. Finally, higher levels of motor impulsivity were associated with a lower probability of suicidal behaviours. Conclusions. Identifying symptom profiles among adolescents who have attempted suicide provides a valuable framework for guiding suicide prevention and personalized interventions. These findings support the use of tailored approaches, such as DBT-A or CBT for internalizing symptoms, and behavioural or family-based interventions for externalizing traits.