Sixty-seven adolescent suicide victims and 67 demographically matched
living controls were compared as to family constellation, familial str
essors and familial loading for psychopathology. Suicide victims were
less likely to have lived with both biological parents, were more like
ly to be exposed to stressors such as parent-child discord, physical a
buse and residential instability and showed greater familial loading f
or depression and substance abuse. Multivariate analyses showed that f
amily history of both depression and substance abuse and lifetime hist
ory of parent-child discord were most closely associated with adolesce
nt suicide. Children who are the offspring of parents with depression
or substance abuse should be psychiatrically screened. Family interven
tions to decrease discord may also be helpful in decreasing the risk o
f adolescent suicide.