Follow-up five years after attempted suicide at age 7

Of 101 adolescents and young adults admitted to a depression inpatient unit, and independently evaluated by researchers and clinicians, only one had ever made a prepubertal suicide attempt. Despite progressively severe primary affective disorder that ultimately led to hospitalization at age 12 1/2, the patient never again attempted to kill himself. In this report we discuss D.'s developmental history, family and individual psychodynamics, psychopathology and treatment. Since the patient had been evaluated by mental health professionals repeatedly from age 5, we had access to a well-documented longitudinal view of his life. His motivation to attempt suicide involved interactions between individual and family dynamics. In addition, however, the occurrence by coincidence of meaningful stress at a phase-specific time of vulnerability was of clinical significance. In our opinion, stressful events which actually occurred and were not the products of fantasy enhanced the likelihood that D.'s only suicide attempt occurred at the point of his life when it did.