Young suicide attempters: a comparison between a clinical and an epidemiological sample.J Am Acad Child Adolesc Psychiatry. 2000 Jul; 39(7):868-75.JA
To compare risk factors for self-harm in 2 groups: hospitalized adolescents who had attempted suicide and adolescents reporting suicide attempts in a community survey.
All suicide attempters aged 13 to 19 years admitted to medical wards (n = 91) in a region of Norway were assessed and interviewed. Risk factors were identified by comparisons with a general population sample participating in a questionnaire study in the same community (n = 1,736). In this population sample, a separate analysis of risk factors for reporting deliberate self-harm (n = 141) was performed, applying bivariate and multivariate logistic regression models.
Adjusted risk factors for suicide attempts in hospitalized adolescents were depression (odds ratio [OR] = 4.7), disruptive disorders (OR = 9.4), low self-worth (OR = 1.3), infrequent support from parents (OR = 3.3) or peers (OR = 3.3), parents' excessive drinking (OR = 4.3), and low socioeconomic status (OR = 2.4). For adolescents who self-reported self-harm, depression (OR = 3.1) and loneliness (OR = 1.13) were significant adjusted risk factors (p < .001). Low self-worth, low socioeconomic status, and little support from parents or peers characterized hospitalized suicidal adolescents compared with those who were not hospitalized.
The risk factors were more powerful for hospitalized than for nonhospitalized adolescents. Prevention efforts should target the same factors for both groups, at a population level for nonhospitalized adolescents and at an individual level for hospitalized adolescents, with a focus on depression, low self-esteem, and family communication.