Mood, Substance Use and Suicidality in Bipolar Adolescents: A Prospective Study

描述（由申请人提供）：青少年自杀是一个主要的公共卫生问题，是全球青少年死亡的第二大原因。 在所有青年精神疾病中，双相情感障碍是自杀风险最大的，其次是物质使用障碍。 情绪障碍和物质使用障碍通常同时发生，两者结合会使青少年自杀完成的风险呈指数级增加。 不幸的是，有效的自杀预防工作，特别是对患有情绪障碍和物质使用的超高风险青年人群，仍然有限。 治疗研究中的这种空白可以通过以下发现来理解：来自各个领域的多种因素导致自杀风险;这些因素仍然过于分散，并且被多重确定为预防干预的最佳目标。因此，该领域的专家呼吁对高风险样本进行前瞻性纵向研究，以系统地调查青少年自杀风险的具体机制。 美国自杀学协会明确指出，需要对物质使用的近端、动态和可改变的因素进行研究，以便为高危人群提供有针对性的预防方法。

DESCRIPTION (provided by applicant): Youth suicide constitutes a major public health problem, ranking as the second leading cause of death for youth worldwide. Of all psychiatric disorders in youth, bipolar disorder imparts the greatest risk for suicide, followed by a substance use disorder. Mood disorder and substance use disorders commonly co-occur, and the combination increase the risk for completed suicide in adolescents exponentially over either disorder alone. Unfortunately, effective suicide prevention efforts, particularly for the ultra-high-risk population of youth with mood disorder and substance use, remain limited. This void in the treatment research may be understood by findings that a multitude of factors from a variety of domains contribute to suicidal risk; such factors remain too diffuse and multiply determined to be considered optimal targets for preventive interventions. Experts in the field have thus called for prospective, longitudinal studies in high-risk samples to systematically investigate specific mechanisms of suicide risk in adolescents. The American Association of Suicidology has specifically identified a need for research on proximal, dynamic and modifiable factors for substance use-to inform targeted preventive approaches for high-risk populations.