Article type
Year
Abstract
Background: Children and adolescents prescribed antidepressant medication, most notably Selective Serotonin Reuptake Inhibitors (SSRIs), are at an increased risk of suicidal ideation and attempt (Hetrick et al., 2007). Although it is good practice to collect and report suicide-related outcomes (SROs) in trials involving SSRIs, there is a large variation in the type of data reported and the scales used to assess such outcomes.
Objectives: To synthesise and describe the most common scales used to measure SROs in children and adolescents prescribed SSRIs, and to provide details of the reliability and validity of such scales where possible. Difficulties in separating suicidal ideation and suicide attempt for the purposes of meta-analyses in Cochrane reviews will be highlighted.
Methods: Reviews published by the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) since 2004, that include SROs in children and adolescents as either a primary or secondary outcome measure were included. There were no exclusions placed on type of disorder.
Results: Scales used to measure suicidal ideation included: The Suicidal Ideation Questionnaire (SIQ; Reynolds et al); SIQ-Junior Version (SIQ-JR; Reynolds et al.); and suicide items contained in the K-SADS. Suicide attempt and completed suicide were most commonly reported as an adverse event of treatment. Some trials contained in reviews measured suicidal events as part of adverse outcomes of treatment only.
Conclusions: A variety of measures are currently being used in trials to assess suicidal ideation and attempt. When embarking on a review where these outcomes are of interest to authors, a clear distinction needs to be made between the types of suicidal outcomes of interest and how these are defined. Furthermore, consideration needs to be taken as to whether suicidal outcomes were measured as part of the trials primary/secondary outcomes, or as an adverse event of treatment only.
Reference
Hetrick S, Merry S, McKenzie J, Sindahl P, ProctorM. Selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in children and adolescents. Cochrane Database of Systematic Reviews, 2007, 18: CD004851.
Objectives: To synthesise and describe the most common scales used to measure SROs in children and adolescents prescribed SSRIs, and to provide details of the reliability and validity of such scales where possible. Difficulties in separating suicidal ideation and suicide attempt for the purposes of meta-analyses in Cochrane reviews will be highlighted.
Methods: Reviews published by the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) since 2004, that include SROs in children and adolescents as either a primary or secondary outcome measure were included. There were no exclusions placed on type of disorder.
Results: Scales used to measure suicidal ideation included: The Suicidal Ideation Questionnaire (SIQ; Reynolds et al); SIQ-Junior Version (SIQ-JR; Reynolds et al.); and suicide items contained in the K-SADS. Suicide attempt and completed suicide were most commonly reported as an adverse event of treatment. Some trials contained in reviews measured suicidal events as part of adverse outcomes of treatment only.
Conclusions: A variety of measures are currently being used in trials to assess suicidal ideation and attempt. When embarking on a review where these outcomes are of interest to authors, a clear distinction needs to be made between the types of suicidal outcomes of interest and how these are defined. Furthermore, consideration needs to be taken as to whether suicidal outcomes were measured as part of the trials primary/secondary outcomes, or as an adverse event of treatment only.
Reference
Hetrick S, Merry S, McKenzie J, Sindahl P, ProctorM. Selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in children and adolescents. Cochrane Database of Systematic Reviews, 2007, 18: CD004851.