[Adolescence, substance abuse and suicide attempt by jumping from a window]

Suicide represents, in France, the second cause of death in youth aged 15 to 24. Sixteen per cent of juvenile mortality is attributable to suicide. The annual incidence of suicide attempts in this age group is estimated at about 40 000 cases. Jumping from high represents 6% of deaths from suicide: girls resort to this method twice as often as boys. The severity of somatic consequences and the frequency of sequels following a jumping from a window can hold center stage for a long time, at the risk of trivializing the psychopathology underlying such a violent acting-out. These clinical situations particularly involve a multidisciplinary follow up including an early and active participation of psychiatric consultation-liaison teams. Jumping from a window can occur even apart from established mental disorders, such as psychotic or mood disorders. Our four case-reports draw attention to risk factors represented by: substance abuse (alcohol, cannabis, but also cocaine, ecstasy...), the notion of previous suicide attempts and various drive disorders having a self-harm value or displaying an underlying impulsiveness (eating disorders, scarifications, shoplifting, running away...), the precipitating role of a recent loss of a parent or an important removal from family environment, the potential influence, especially in this age group, of spectacular cases of suicide amplified by the Medias ("Werther effect"). Paradoxically, to belong to a well-off milieu can also contribute to the risk of such acting-out, when parents replace affection and availability by an easy access to various consumer goods and a permissive education, thus opening the way to the encounter with different substances.