PSYCHIATRIC-DIAGNOSIS IN CHILD AND ADOLESCENT SUICIDE

Background: The age, sex, and ethnic distribution of adolescents who c ommit suicide is significantly different from that of the general popu lation. The present study was designed to examine psychiatric risk fac tors and the relationship between them and demographic variables. Meth ods: A case-control, psychologic autopsy study of 120 of 170 consecuti ve subjects (age, <20 years) who committed suicide and 147 community a ge-, sex-, and ethnic-matched control subjects who had lived in the Gr eater New York (NY) area. Results: By using parent informants only, 59 % of subjects who committed suicide and 23% of control subjects who me t DSM-III criteria for a psychiatric diagnosis, 49% and 26%, respectiv ely, had had symptoms for more than 3 years, and 46% and 29%, respecti vely, had had previous contact with a mental health professional. Best -estimate rates, based on multiple informants for these parameters, fo r suicides only, were 91%, 52%, and 46%, respectively. Previous attemp ts 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 ex clusively in males (62% of 18- to 19-year-old suicides). The prevalenc e of a psychiatric diagnosis and, in particular, substance and/or alco hol abuse increased with age. Conclusion: A limited range of diagnoses -most commonly a mood disorder alone or in combination With conduct di sorder and/or substance abuse-characterizes most suicides among teenag ers.