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Depression, family environment, and adolescent suicidal behavior

C Hollis1

  • 1Department of Child and Adolescent Psychiatry, Institute of Psychiatry, London, UK.

Journal of the American Academy of Child and Adolescent Psychiatry
|May 1, 1996
PubMed
Summary

Family relationship difficulties significantly increase adolescent suicide risk, independent of depression. While depression is a major risk factor, family discord and poor relationships also contribute substantially to suicidal behavior in teens.

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Area of Science:

  • Psychiatry
  • Adolescent Health
  • Mental Health Research

Background:

  • Adolescent suicidal behavior is a significant public health concern.
  • Depression is a known risk factor for suicidal behavior in adolescents.
  • The independent contribution of family relationship difficulties requires further elucidation.

Purpose of the Study:

  • To determine if family relationship difficulties increase the risk of adolescent suicidal behavior, beyond the impact of depression.
  • To investigate specific aspects of family relationships associated with suicidal behavior.

Main Methods:

  • Retrospective analysis of clinical data from adolescents (1970s-1980s).
  • Comparison of 284 cases of suicidal behavior with 3,054 non-suicidal controls.
  • Stepwise logistic regression controlling for age and sex.

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Main Results:

  • Depressive syndrome (OR=4.4), family discord (OR=1.5), disturbed mother-child relationship (OR=1.5), and lack of familial warmth (OR=1.6) were independently associated with suicidal behavior.
  • Twenty-seven percent of suicidal cases met criteria for depression.
  • In non-depressed cases, female gender (OR=2.4) and conduct symptoms (OR=1.45) were risk factors; these factors did not influence risk in depressed cases.

Conclusions:

  • Family relationship difficulties contribute independently to adolescent suicidal behavior risk, alongside depression.
  • Depression is the largest single risk factor, but family factors are significant.
  • The interaction between depression and gender indicates that increased suicidal behavior risk in females is primarily in non-depressed adolescents.