Suicidal behaviours in vulnerable adolescents

Eric J Fombonne

80 citations0/0 files storedThe British Journal of Psychiatry

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Suicide and Self-Harm Studies Substance Abuse Treatment and Outcomes Homicide, Infanticide, and Child Abuse

Abstract

BACKGROUND: Suicide rates have increased over the past three decades, especially in young men. Depression, conduct disorder, crime and substance misuse have also increased. This study tested hypotheses on the possible links between the secular increase in the rates of these behaviours. METHOD: A data set on 6091 subjects aged 8-18 years (58.4% boys) referred to psychiatric services over a 21-year period (1970-1990) was used. A detailed analysis of a random sample of 80 case notes was conducted. RESULTS: Suicidal behaviours increased significantly among pubertal male adolescents only (n = 1313). In this sub-sample, substance misuse accounted for the increase over time. The rates of both suicidal behaviours and of substance misuse almost doubled between 1979 and 1990 in this patient group. The case note analysis showed that solvent and alcohol misuse had also increased over the study period. Moreover, among the subjects misusing substances, alcohol was the only substance with a strong and positive association with suicidal behaviours. Substance misuse pre-dated suicidal behaviours in most patients. CONCLUSIONS: A link has been found between the increase over time of suicidal behaviors in adolescent boys and a contemporaneous increase in substance misuse. The strength and direction of the association suggests that alcohol misuse is the causal factor.

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References

1996Psychiatric Diagnosis in Child and Adolescent Suicide 1993Psychiatric Risk Factors for Adolescent Suicide: A Case-Control Study 1996Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study 1996Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study 1991Mental Disorders in Adolescent Suicide 1997Reviews 1996Risk Factors for Serious Suicide Attempts among Youths Aged 13 through 24 Years 1993Aggression, substance use, and suicidal behaviors in high school students.

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2003Life Course Factors Associated With Suicidal Behaviors in Young People 2000The association of suicide attempts and comorbid depression and substance abuse in psychiatric consultation patients 1998Gender differences in rates and correlates of suicidal behaviour amongst child psychiatric outpatients

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