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The aim of this study was to explore these associations in a clinical sample of adolescents with substance use disorder (SUD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The sample included\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009342 adolescents aged 12 to 19 years from a specialized SUD outpatient unit. They reported on their substance use, trauma history, symptoms of posttraumatic stress disorder (PTSD) and depression, and life satisfaction either in a structured clinical interview or standardized questionnaires; they also completed a task assessing inhibitory control. These variables were compared for adolescents with and without suicidal ideation or behavior. Classification and Regression Trees (CART) models were developed to describe subgroups of participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Overall, 34.2% of adolescent SUD outpatients reported suicidal ideation in the last two weeks and 26.0% fulfilled the criteria for suicidal behavior disorder in the last two years according to DSM-5. Female gender (OR\u2009=\u20092.88 and OR\u2009=\u20094.30) and sexual abuse (OR\u2009=\u20094.55 and OR\u2009=\u20095.33) were associated with higher odds of both suicidal ideation and behavior, respectively. Adolescents with suicidal ideation or behavior had significantly more severe SUD-related problems (\n                      <jats:italic>d<\/jats:italic>\n                      = -0.46 and\n                      <jats:italic>d<\/jats:italic>\n                      = -0.36), symptoms of PTSD (\n                      <jats:italic>d<\/jats:italic>\n                      = -1.38 and\n                      <jats:italic>d<\/jats:italic>\n                      = -1.04) and of depression (\n                      <jats:italic>d<\/jats:italic>\n                      = -1.77 and\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u2212\u20090.89) and lower life satisfaction (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.98 and\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.81). The CART models identified symptoms of depression and PTSD as the variables that best distinguished participant subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results indicate high rates of suicidal ideation and behavior in adolescents with SUD and underline the importance of assessing trauma when identifying and preventing suicidality in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13034-026-01165-7","type":"journal-article","created":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T01:34:01Z","timestamp":1788053641000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trauma and suicidality in adolescents with substance use disorders"],"prefix":"10.1186","volume":"20","author":[{"given":"Mira","family":"Vasileva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"Kuitunen-Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit","family":"Roessner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgenii","family":"Shvedovskii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Clemens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg M.","family":"Fegert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulia","family":"Golub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"issue":"10036","key":"1165_CR1","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1016\/S0140-6736(16)00648-6","volume":"387","author":"AH Mokdad","year":"2016","unstructured":"Mokdad AH, Forouzanfar MH, Daoud F, Mokdad AA, El Bcheraoui C, Moradi-Lakeh M, et al. 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