To investigate the characteristics of adolescent suicide attempters in Taiwan, compare with Western reports and provide reference for suicide preventive interventions in adolescence.
During a 3-year period, the charts of 109 adolescent psychiatric inpatients were retrospectively reviewed. Twenty-eight adolescents admitted to an acute psychiatric ward as a result of recent suicide attempts were investigated to unravel factors related to suicide. Fifty-five adolescents with at least 1 suicide attempt recently or in the past were analyzed for risk factors of suicidal behavior compared to others.
Of the 109 adolescents admitted, 28 (25.6%) patients had been admitted due to recent suicide attempt. The most common diagnosis was depressive disorder (50%), followed by bipolar disorder (14.3%), schizophrenia (14.3%), and finally adjustment disorder (10.7%). There were significantly more girls than boys who attempted suicide. Suicide attempts increased with age, but this trend was not statistically significant. The most common precipitating factors were school stress (46%), parent-child conflict (25%), and psychopathology (25%) including feeling of hopelessness and psychotic symptoms. Adolescents with substance abuse or panic symptoms comprised a higher risk group for suicide. After discharge, 34.9% (38/109) of patients were lost to follow-up, and 15.5% (11/71) of the follow-up patients continued to manifest suicidal behavior.
Our study confirms some previous Western reports that adolescents with depressive disorders commonly manifest suicide attempts. There are, however, some cultural differences in risk factors. School-related problems play an important role in Taiwan among the adolescent suicides, and prior suicide attempts predict future suicidal behavior. Enhancing school-based screening for adolescents with suicide risk and transferring them to psychiatric professionals for intervention is important. We should focus suicide prevention resources mainly on the adolescent population with psychiatric illness, prior suicide attempts, and with high risk factors.