Suicide-Related Outcomes Among Adolescent Clinical Populations: The Effect of Sex on Preventive Factors

Abstract

Introduction. Suicide-related outcomes (SROs), such as ideation and attempts, are among the leading causes of mortality in adolescents in clinical settings. Developing culturally and sex-specific strategies to identify high-risk adolescents is crucial for enabling immediate preventive interventions. Objective. To compare adolescents’ sociodemographic and clinical characteristics with (non)-SROs and (ideation/attempt)-SROs, stratified by sex, and to analyze their relationship with psychopathology factors. Method. A cross-sectional, multi-informant study was conducted using consecutive sampling during routine clinical visits and an assessment tool collected sociodemographic, clinical, general severity, and overall functioning data. Differences between groups were analyzed, and exploratory factor analysis was performed to identify latent psychopathology factors. Results. Males exhibited significantly more (ideation/attempt)-SROs than females (n = 143, 58 [40.56 %] vs. n = 158, 52 [32.91 %], U = 7585.5, p = .0135). In (ideation)-SROs, males had higher total psychopathology scores, while females scored significantly higher in internalized and neurodevelopmental factors. In (attempt)-SROs, females showed higher scores in psychotic factors. Discussion and conclusion. Adolescents with (ideation/attempt)-SROs presented higher psychopathology levels. Whereas males reported more SROs overall, females scored higher in internalized symptoms. Recognizing internalized and neurodevelopmental factors may enhance early detection and prevention efforts, particularly in adolescent females. © 2025 Instituto Nacional de Psiquiatria Ramon de la Fuente.