PSYCHIATRIC RISK-FACTORS FOR ADOLESCENT SUICIDE - A CASE-CONTROL STUDY

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.