Suicidal adolescents: factors in evaluation

Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.