Clinical and Familial Predictors of Suicidal Ideation and Treatment Outcomes in Hospitalized Adolescents in Turkey: A Retrospective Analysis

Abstract

Highlights What are the main findings? Major depressive disorder and a previous suicide attempt were the strongest predictors of suicidal ideation among hospitalized adolescents. Longer length of hospitalization was the only independent predictor of clinical improvement during inpatient treatment. What are the implications of the main findings? Adolescents admitted with depressive disorders and prior suicide attempts should be prioritized for intensive suicide risk assessment and monitoring. Ensuring adequate inpatient treatment duration may improve clinical stabilization and treatment outcomes in adolescent psychiatric care.Highlights What are the main findings? Major depressive disorder and a previous suicide attempt were the strongest predictors of suicidal ideation among hospitalized adolescents. Longer length of hospitalization was the only independent predictor of clinical improvement during inpatient treatment. What are the implications of the main findings? Adolescents admitted with depressive disorders and prior suicide attempts should be prioritized for intensive suicide risk assessment and monitoring. Ensuring adequate inpatient treatment duration may improve clinical stabilization and treatment outcomes in adolescent psychiatric care.Abstract Background/Objectives: Adolescent psychiatric inpatient units play a critical role in the management of severe psychiatric disorders and suicide risk. However, limited evidence exists regarding the clinical and familial factors that simultaneously influence suicidal ideation and treatment outcomes in hospitalized adolescents. This study aimed to identify demographic, diagnostic, and clinical predictors of suicidal ideation and clinical improvement among adolescents hospitalized in a tertiary child and adolescent psychiatry inpatient unit. Methods: This retrospective observational study included 75 adolescents aged 12-18 years who were hospitalized in a tertiary child and adolescent psychiatry inpatient unit between November 2023 and June 2025. Sociodemographic and clinical characteristics were obtained from medical records. Clinical improvement was evaluated using the Clinical Global Impression-Improvement (CGI-I) scale. Group comparisons were conducted using chi-square or Fisher's exact tests for categorical variables and the Mann-Whitney U test for continuous variables. Multivariate logistic regression analyses were performed to determine independent predictors of suicidal ideation and clinical improvement. Results: Clinical improvement was evaluated in the full sample of adolescents (n = 75), and longer length of stay was independently associated with clinical improvement during hospitalization. Among adolescents admitted with suicidal ideation (n = 45), major depressive disorder, previous suicide attempt, irritability at admission, and fewer siblings were identified as independent predictors of suicidal ideation. In addition, female adolescents had higher rates of suicide attempts and non-suicidal self-injury, whereas psychotic disorders were more common among male adolescents. Conclusions: Suicidal ideation in hospitalized adolescents is strongly associated with affective pathology and prior suicidal behavior. Longer inpatient treatment duration appears to facilitate clinical improvement. These findings highlight the importance of early suicide risk stratification and adequate treatment duration in adolescent psychiatric inpatient care.