Maternal versus adolescent reports of suicidal behaviors: a nationwide survey in Israel.

Community and nationwide surveys on adolescent suicidal behaviors using clinical interviews are not abundant. Rates of self-reported suicide attempts in community samples vary greatly between 1 and 20 %. In general, adolescent and parental agreement in child psychiatry practice is low, and their agreement with regard to suicidal behavior is unknown. The current study assesses the rates of suicidal ideation and behaviors as well as the rate of agreement between adolescents and their mothers in a representative nationwide sample. The survey included a representative and randomized community sample of 14- to 17-year-old adolescents (n = 957), and their mothers who were interviewed using the Development and Well-Being Assessment Inventory (DAWBA). The prevalence of suicidal ideation and self-initiated behaviors was 4.9 and 1.9 %, respectively. The concordance between mothers' and adolescents' reporting on ideation was low (7.3 %). There was no concordance between mothers' and adolescents' reports of suicidal acts. Adolescents reported self-initiated behaviors nearly three times more frequently than their mothers. Paternal unemployment, care by welfare agencies and having a psychiatric disorder, specifically depression or post-traumatic stress disorder, was associated with a higher risk for both suicidal ideation and attempts. In this nationwide community study, by evaluating information gathered by clinical interviews, it was found that the lifetime rates of suicidal ideation were moderate. The rates of suicide attempts were lower than have been previously reported. The concordance between the reports of adolescents and their mothers was low for ideation and nonexistent for attempts. Thus, clinicians should interview adolescents separately from their mothers regarding their suicidality.

Prevalence and correlates of mental disorders in Israeli adolescents: results from a national mental health survey.

BACKGROUND: The development of epidemiological instruments has enabled the assessment of mental disorders in youth in countries that plan policy according to evidence-based principles. The Israel Survey of Mental Health among Adolescents (ISMEHA) was conducted in 2004-2005 in a representative sample of 957 adolescents aged 14-17 and their mothers. METHODS: The aims of this study were to estimate prevalence rates of internalizing and externalizing mental disorders and their socio-demographic and health correlates. Disorders were ascertained with the Development and Well-Being Assessment inventory and verified by child psychiatrists. RESULTS: The prevalence rates were 11.7%, 8.1% and 4.8% for any disorder, internalizing disorders and externalizing disorders, respectively. Distinct risk factors were associated with the different types of disorders: internalizing disorders were associated with female gender, chronic medical conditions and being cared for by a welfare agency. Risk factors for externalizing disorders were male gender, having divorced or single parents, being an only child or having only one sibling. Learning disability was associated with both types of disorders. CONCLUSIONS: The risk and protective factors related to internalizing and externalizing disorders are interpreted within the framework of family composition in this multicultural society.

The Israel Survey of Mental Health Among Adolescents: aims and methods?

OBJECTIVE: The Israel Survey of Mental Health among Adolescents (ISMEHA) aimed to ascertain the prevalence of selected mental disorders and patterns of comorbidity, service utilization and unmet needs, health and sociodemographic covariates, and risk and protective factors. This paper reviews the methods used and discusses the strengths and limitations of the survey. METHOD: The ISMEHA was a cross-sectional survey that included 957 Israeli adolescents, representative of the adolescent population aged 14-17 years. The Strengths and Difficulties Questionnaire, Hebrew version (SDQ-H), the Development and Well-Being Assessment (DAWBA) inventory, services utilization, health status and sociodemographic questions were administered to adolescents and their mothers at the respondents homes between January 2004 and March 2005. RESULTS: The overall response rate was 68.2%, and it varied by gender and type of locality. Among boys, 71.3% responded, as compared to 65.2% among girls. The response rate among adolescents living in a Jewish or mixed city was 62.5% as compared to 89.6% among adolescents living in an exclusively Arab-populated city. CONCLUSIONS: The ISMEHA allows the creation of a unique and comprehensive database informing on the prevalence, burden, services utilization and unmet needs of adolescents with psychiatric disorders. These data will enable policymakers to more rationally plan services and prevention programs for the target population.