Factors Associated with Repeat Suicide Attempts among Adolescents

Jacqualine Vajda · Katharine S. Steinbeck

123 citations0/0 files storedAustralian & New Zealand Journal of Psychiatry

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Suicide and Self-Harm Studies Injury Epidemiology and Prevention Homicide, Infanticide, and Child Abuse

Abstract

OBJECTIVE: To determine potential risk factors associated with repeat suicide attempts among adolescents. METHOD: Retrospective medical record review of all patients aged 13-20 years who presented to the emergency department at an inner city tertiary hospital after attempted suicide between 1994 and 1996. Subjects were identified using the International Classification of Diseases (ICD-9) codes E950.0 to E959.9 for attempted suicide. Study variables included demographic parameters, chronic medical conditions/illnesses, psychiatric and substance abuse disorders, history of sexual abuse and previous and subsequent suicide attempts. Variables univariately associated with repetition at p < 0.25 were entered into a multiple regression analysis. RESULTS: Eighty seven per cent of patients presented with a drug overdose. Seventy-six per cent of all subjects attempted suicide in the context of a dispute or relationship break-up. At least one psychiatric disorder was present in 76% of subjects at the index attempt. The most frequently diagnosed disorders were depression (45.5%) and drug (34%) and alcohol abuse (27%). Variables predicting repetition within 12 months were drug (OR = 3.891, p = 0.02) and alcohol abuse (OR = 3.56, p = 0.05), non-affective psychotic disorders (OR = 3.81, p = 0.04), and chronic medical conditions/illness (OR = 3.29, p = 0.03). A history of sexual abuse was almost significant (OR = 3.03, p = 0.06). CONCLUSIONS: Adolescents most likely to re-attempt suicide with 12 months present with either substance abuse, non-affective psychotic disorders, chronic medical conditions, or a history of sexual abuse. All adolescents with a possible suicide attempt should receive a comprehensive mental health and psychosocial assessment. Closer scrutiny of the role of chronic illnesses and sexual abuse in both future research and clinical management is urged. A broad based, multidisciplinary intervention approach is recommended.

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References

1987The New Zealand Medical Journal 1887-1987.1988Risk Factors for Adolescent Suicide 1994Psychosocial risk factors for future adolescent suicide attempts.1993Depressive comorbidity in children and adolescents: empirical, theoretical, and methodological issues 1996Psychosocial Risk Factors of Child and Adolescent Completed Suicide 1995Symptoms versus a diagnosis of depression: Differences in psychosocial functioning.1992Suicidal Attempts among Older Adolescents: Prevalence and Co-occurrence with Psychiatric Disorders 1991Mental Disorders in Adolescent Suicide

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