Screening teens for suicide risk is among the recommendations in a new clinical report from the American Academy of Pediatrics Committee on Adolescence. Suicide is now the second-leading cause of death for teens aged 15-19 years, having surpassed homicide since 2007. 

RISK FACTORS FOR SUICIDE IN TEENS

FIXED RISK FACTORS

 Family history of suicide or suicide attempts.

• History of adoption.

• Male gender.

• Parental mental health problems.

• Lesbian, gay, bisexual, or questioning sexual orientation.

• A history of physical or sexual abuse.

• Previous suicide attempt.

SOCIAL/ENVIRONMENTAL RISK FACTORS

Bullying.

• Impaired parent-child relationship.

• Living outside of the home (homeless or in a corrections facility or group home).

• Difficulties in school.

• Not attending school.

• Social isolation.

• Presence of stressful life events, such as legal or romantic difficulties or an argument with a parent. 

PERSONAL MENTAL HEALTH PROBLEMS

Sleep disturbances. 

• Depression. 

• Bipolar disorder. 

• Substance intoxication and substance use disorders. 

• Psychosis.

• Posttraumatic stress disorder.

• Panic attacks. 

• A history of aggression.

• Impulsivity. 

• Severe anger. 

• Pathologic Internet use.

Self-report scales may be helpful, but they do not substitute for clinicians/family members asking teens directly (and sensitively) about mood disorders, substance use, suicidal and self-harmful thoughts, behaviors, stress, and distress.

A significant risk factor for suicide is involvement in bullying, whether the teen is the victim, the bully, or both, with the latter – bully victims – at the highest risk. The increased risk for suicidal thoughts or attempts extends to involvement with cyberbullying, in addition to physical, social, and verbal bullying.

Girls who are victims or perpetrators of bullying are at higher risk for suicidal thoughts or attempts regardless of how common or rare the bullying is, whereas boys had an increased risk only when the bullying was frequent. Bullying as early as age 8 years was associated with attempted and completed suicides in adolescence.

In a 2013 survey of U.S. high school students, 24% of girls and 16% of boys reported being bullied on school property in the past year. Cyberbullying occurred among 21% of the girls and 9% of the boys.

Teens reporting video game or Internet use for at least 5 hours a day were at higher risk for suicidal thoughts, suicide attempts, and depression. An additional wrinkle of Internet use is that teens may read about others’ suicides, which increases their own risk, or they may seek out pro-suicide websites.

Despite the negatives, there is evidence that the Internet and electronic media, in general, provide a large amount of support, including keeping teens connected to their friends, family, teachers, and others, and also providing entertainment and valuable or interesting information. The Internet may be particularly useful for distressed teens.

More than 90% of adolescent suicide victims met criteria for a psychiatric disorder before their death. Immediate risk factors include agitation, intoxication, and a recent stressful life event.

TAKE ACTION TO HELP AT-RISK TEENS

  1. Ask questions about mood disorders, depression, agitation, use of drugs and alcohol, suicidal thoughts, bullying, sexual orientation, and other risk factors associated with suicide throughout adolescence.
  2. Keep in touch with emergency departments and colleagues in child and adolescent psychiatry, clinical psychology, and other mental health professions to optimally evaluate and manage the care of adolescents who are at risk for suicide.
  3. Advise parents to remove guns and ammunition from the house and secure supplies of prescription and over-the-counter medications.
  4. Educate the family regarding the following warning signs: new or more frequent thoughts of wanting to die; self-destructive behavior; signs of increased anxiety/panic, agitation, aggressiveness, impulsivity, insomnia or irritability; new or more involuntary restlessness, such as pacing or fidgeting; extreme degree of elation or energy; fast, driven speech; or new onset of unrealistic plans or goals.

N.B: This article has been written to increase the awareness about 'adolescent suicide' on the "WORLD SUICIDE PREVENTION DAY-10 Th SEPTEMBER"