Risk for suicidal problems in poor-help-seeking adolescents with psychotic-like experiences: Findings from a cross-sectional survey of 16,131 adolescents

摘要

Background: Recent evidence suggests that psychotic-like experiences (PLEs) in the general population are important markers of risk of suicidal problems. However, there have been no epidemiological studies investigating help-seeking status in individuals with PLEs and elevated risk of suicide.Methods: Information on PLEs, self-awareness of mental distress (SAMD), help-seeking behaviours (HSBs), and suicidal problems was collected from 16,131 Japanese adolescents. Participants were divided into two groups, those with and without PLEs, and then both groups were further divided into three subgroups: a group without SAMD, who had no HSB by definition; a group with both SAMD and HSB; and a group with SAMD but without HSB (poor-help-seeking group), yielding a total of six groups.Results: Adolescents with PLEs (14.3%) had significantly higher risk of suicidal problems than those without PLEs. Among the individuals with both PLEs and SAMD, 3 8.1 % did not seek any help (poor-help-seeking status). Among the six groups, odds of suicidal ideation was the highest among poor-help-seeking adolescents with PLEs, with a 20-fold increase compared to those without PLEs, SAMD and HSB (adjusted for age and sex), while the odds was increased 10-fold in those with PLEs, SAMD and HSB. After adjusting for anxiety/depression level, the odds ratios remained significant in both poor-help-seeking adolescents with PLEs (OR = 3.8 [3.0-4.9 (95% CI)]) and those with PLEs, SAMD and HSB (OR = 2.5 [2.0-3.1 ]).Conclusions: Adolescents with PLEs and self-awareness of mental distress are at high risk for suicidal problems, particularly those without help seeking.