Psychiatric Diagnosis in Child and Adolescent Suicide

TLDR

Adolescent suicide differs markedly in age, sex, and ethnicity from the general population. The study aimed to examine psychiatric risk factors and their relationship to demographic variables among teenage suicide victims. Researchers conducted a case‑control psychologic autopsy of 120 of 170 consecutive suicide cases (under 20) and 147 matched community controls from Greater New York. Among adolescents who committed suicide, 91% had a psychiatric diagnosis, 52% had symptoms for over three years, and 46% had prior mental‑health contact; previous attempts and mood disorders were major risk factors for both sexes, substance/alcohol abuse was a male‑only risk factor, and the prevalence of diagnosis and substance abuse rose with age, indicating that most teenage suicides involve mood disorders alone or combined with conduct disorder and/or substance abuse.

Abstract

<h3>Background:</h3> The age, sex, and ethnic distribution of adolescents who commit suicide is significantly different from that of the general population. The present study was designed to examine psychiatric risk factors and the relationship between them and demographic variables. <h3>Methods:</h3> A case-control, psychologic autopsy study of 120 of 170 consecutive subjects (age, &lt;20 years) who committed suicide and 147 community age-, sex-, and ethnic-matched control subjects who had lived in the Greater New York (NY) area. <h3>Results:</h3> By using parent informants only, 59% of subjects who committed suicide and 23% of control subjects who met<i>DSM-III</i>criteria for a psychiatric diagnosis, 49% and 26%, respectively, had had symptoms for more than 3 years, and 46% and 29%, respectively, had had previous contact with a mental health professional. Best-estimate rates, based on multiple informants for these parameters, for suicides only, were 91%, 52%, and 46%, respectively. Previous attempts and mood disorder were major risk factors for both sexes; substance and/or alcohol abuse was a risk factor for males only. Mood disorder was more common in females, substance and/or alcohol abuse occurred exclusively in males (62% of 18-to 19-year-old suicides). The prevalence of a psychiatric diagnosis and, in particular, substance and/or alcohol abuse increased with age. <h3>Conclusion:</h3> A limited range of diagnoses—most commonly a mood disorder alone or in combination with conduct disorder and/or substance abuse—characterizes most suicides among teenagers.