Da. Brent et al., PSYCHIATRIC RISK-FACTORS FOR ADOLESCENT SUICIDE - A CASE-CONTROL STUDY, Journal of the American Academy of Child and Adolescent Psychiatry, 32(3), 1993, pp. 521-529
Objective: The objective of this study was to determine the psychiatri
c risk factors for adolescent suicide. Method: Sixty-seven adolescent
suicide victims were compared with 67 demographically matched communit
y controls. Psychiatric disorder was assessed in suicide victims using
a psychological autopsy protocol and in controls using similar semist
ructured psychiatric interviews. Risk factors were quantified by use o
f the odds ratio (OR), that is, the relative frequency of the occurren
ce of a given condition in the suicides compared with the controls. Re
sults: The most significant psychiatric fisk factors associated with a
dolescent suicide were major depression (OR = 27.0), bipolar mixed sta
te (OR = 9.0), substance abuse (OR = 8.5), and conduct disorder (OR =
6.0). Substance abuse was a more significant risk factor when comorbid
with affective illness than when alone (OR = 17.0 versus 3.3). The ma
jority of depressed suicide victims had a primary affective disorder (
82%). A significant minority (31%) of depressed suicide victims had be
en depressed less than 3 months. Previous suicide attempts, suicidal i
deation, and homicidal ideation also were associated with adolescent s
uicide. Conclusions: The development of effective treatments for youth
who fit the above-noted risk profiles should be given high priority.