Risk Factors for Adolescent Suicide

TLDR

Adolescent suicides and high‑risk inpatients share high rates of affective disorders and family histories of affective, antisocial disorders, and suicide, indicating a continuum of suicidality from ideation to completion. The study compared characteristics of 27 adolescent suicide victims with 56 high‑risk suicidal psychiatric inpatients who had either seriously considered or attempted suicide. Four risk factors—bipolar disorder, comorbid affective disorder, lack of prior mental‑health treatment, and home firearm availability—identified in suicide victims predicted 81.9% of cases, and completers had higher intent than attempters, highlighting a high‑risk psychiatric profile that could inform prevention.

Abstract

• The characteristics of adolescent suicide victims (n = 27) were compared with those of a group at high risk for suicide, suicidal psychiatric inpatients (n = 56) who had either seriously considered (n = 18) or actually attempted (n = 38) suicide. The suicide victims and suicidal inpatients showed similarly high rates of affective disorder and family histories of affective disorder, antisocial disorder, and suicide, suggesting that among adolescents there is a continuum of suicidality from ideation to completion. However, four putative risk factors were more prevalent among the suicide victims: (1) diagnosis of bipolar disorder; (2) affective disorder with comorbidity; (3) lack of previous mental health treatment; and (4) availability of firearms in the homes, which taken together accurately classified 81.9% of cases. In addition, suicide completers showed higher suicidal intent than did suicide attempters. These findings suggest a profile of psychiatric patients at high risk for suicide, and the proper identification and treatment of such patients may prevent suicide in high-risk clinical populations.