AJN, American Journal of Nursing:
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At least one mental disorder usually precedes suicidal behaviors.
Although suicide is a leading cause of death among U.S. adolescents, little is known about its prevalence, correlates, or treatment. New results from a nationally representative survey indicate that more than 12% of U.S. adolescents have thoughts of suicide. And most adolescents with a lifetime history of suicidal thoughts or attempts have at least one mental disorder; most, too, have received some form of treatment, but that appears not to deter them from planning or attempting suicide, the investigators found.
Researchers interviewed 6,483 adolescents 13 to 18 years of age about suicidal behaviors, including ideation, planning, and attempts. Participants’ parents completed questionnaires about the adolescent's mental health. Adolescents also completed a structured interview about mental disorders, broadly categorized as fear and anger disorders, distress disorders, disruptive behavior disorders, and substance abuse disorders; the prevalence of bipolar disorder was also assessed.
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Based on the findings, the researchers estimate that 12% of U.S. adolescents experience suicidal ideation, 4% make suicide plans, and 4% attempt suicide. Most of those with a lifetime history of suicidal ideation and attempts meet criteria from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders for at least one mental disorder, most often major depressive disorder or dysthymia. Approximately 60% of those with a suicide plan go on to attempt suicide, usually within one year.
The prevalence of suicidal ideation is very low through 10 years of age, increases slowly through 12 years, and increases more rapidly between 12 and 17 years. Girls are significantly more likely to experience suicidal ideation or make an attempt than boys.
More than 80% of suicidal adolescents receive some type of mental health treatment before the onset of suicidal behavior, although the authors note that in some cases the services received may not qualify as “treatment.”
The authors say that the findings suggest a need for close monitoring of adolescents with a suicide plan, especially within the first year of onset, and they call for the development of practical strategies for predicting and preventing suicidal behaviors.—Karen Rosenberg
Nock MK, et al. JAMA Psychiatry 2013 Jan 9. [Epub ahead of print.]
© 2013 Lippincott Williams & Wilkins, Inc.