Adjustment disorder and the course of the suicidal process in adolescents.

BACKGROUND Adjustment disorders are often associated with suicidal behaviour but there is little information regarding the nature of the relationship and the effect of adjustment disorders on the suicidal process. The authors' goal was to investigate the association of adjustment disorders (with depressed mood) and suicide in adolescents by means of a psychological autopsy study. METHOD Relatives and other informants of 19 suicide victims were interviewed by means of a semi-structured interview schedule. Differences in duration of the suicidal process between suicide victims diagnosed with adjustment disorder and suicide cases diagnosed with other psychiatric disorders were examined. RESULTS The suicidal process was significantly shorter in suicide victims diagnosed with adjustment disorder compared with suicide cases diagnosed with other disorders. No indications of a history of emotional or behavioural problems during early adolescence were found in suicide cases diagnosed with adjustment disorder. LIMITATIONS The study sample consists of a small sample size and retrospective interviews of relatives were used. CONCLUSIONS The suicidal process in suicide victims diagnosed with adjustment disorder appears to be short and rapidly evolving without any prior indications of emotional or behavioural problems. The importance of assessing the suicidal risk in patients diagnosed with adjustment disorder is underlined.