Suicide attempts or threats by children and adolescents in Johannesburg

Current literature on suicide attempts by children and adolescents is reviewed. The records of children and adolescents in the 10-15-year age group who were referred to a child psychiatric unit over the 6-year period 1 January 1977-31 December 1982 were analysed. The results are presented and discussed. Suicide attempts or threats together constituted an average of 10% of the psychiatric referrals in this age group, the figure for 1982 being substantially increased. The peak incidence was among 13-year-olds for both boys and girls. The female: male referral ratio was 2:1. Drug overdosage was the most common method, the commonly employed drugs being analgesics and benzodiazepines. In about 30% of both the boys and girls referred because of taking an overdose, a multiple-drug overdose had been used. Methods other than this were used three times more frequently by boys than by girls. Major predisposing and antecedent factors were family stress (especially divorce), psychiatric illness in the patient or a family member, and school problems. Some 30% had previously made suicide attempts or threats, and at least 7% made further serious suicide attempts after initial treatment. These results suggest a need for further investigations into factors relating to suicide attempts or threats in children and adolescents and their subsequent management.