Abstract
Suicide is rare in childhood and early adolescence, and becomes more frequent with increasing age. The latest mean worldwide annual rates of suicide per 100 000 were 0.5 for females and 0.9 for males among 5–14-year-olds, and 12.0 for females and 14.2 for males among 15–24-year-olds, respectively. In most countries, males outnumber females in youth suicide statistics. Although the rates vary between countries, suicide is one of the commonest causes of death among young people. Due to the growing risk for suicide with increasing age, adolescents are the main target of suicide prevention. Reportedly, less than half of young people who have committed suicide had received psychiatric care, and thus broad prevention strategies are needed in healthcare and social services. Primary care clinicians are key professionals in recognizing youth at risk for suicide.
This article reviews recent population-based psychological autopsy studies of youth suicides and selected follow-up studies of clinical populations and suicide attempters, analyzing risk factors for youth suicides. As youth suicides are rare, research on risk factors for youth suicidal ideation and attempted suicide is also briefly reviewed.
The relationship between psychiatric disorders and adolescent suicide is now well established. Mood disorders, substance abuse and prior suicide attempts are strongly related with youth suicides. Factors related to family adversity, social alienation and precipitating problems also contribute to the risk of suicide. The main target of effective prevention of youth suicide is to reduce suicide risk factors. Recognition and effective treatment of psychiatric disorders, e.g. depression, are essential in preventing child and adolescent suicides. Research on the treatment of diagnosed depressive disorders and of those with suicidal behavior is reviewed.
In the treatment of youth depression, psychosocial treatments have proved to be useful and efficacious. Although studies on the effectiveness of selective serotonin reuptake inhibitors are limited in number, evidence supports their use as first-line antidepressant medication in youth depression. Available evidence suggests that various treatment modalities are useful in the treatment of suicidal youths, e.g. cognitive behavioral therapy and specialized emergency room interventions. Much of the decrease in suicide ideation and suicide attempts seems to be attributable to nonspecific elements in treatment. For high-risk youth, providing continuity of care is a challenge, since they are often noncompliant and commonly drop out or terminate their treatment prematurely. Developing efficacious treatments for suicidal children and adolescents would offer better possibilities to prevent suicides.
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References
Statistics Finland. Causes of death 2000. Helsinki: Statistics Finland, 2002
WHO Statistical Information System. WHO, 2001 [online]. Available from URL: http://w.who.int\osis [Accessed 2003 Mar 5]
McClure GMG. Suicide in children and adolescents in England and Wales 1970–1998. Br J Psychiatry 2001; 178: 469–74
Lewinsohn PM, Rohde P, Seeley JR, et al. Gender differences in suicide attempts from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry 2001; 40: 427–34
Fleming JE, Offord DR. Epidemiology of childhood depressive disorders: a critical review. J Am Acad Child Adolesc Psychiatry 1990; 29: 571–80
McGee R, Feehan M, Williams S, et al. DSM-III disorders from age 11 to age 15 years. J Am Acad Child Adolesc Psychiatry 1992; 31: 50–9
Shaffer D, Garland A, Vieland V, et al. The impact of curriculum-based suicide prevention, programs for teenagers. J Am Acad Child Adolesc Psychiatry 1991; 30: 588–96
Brent DA, Perper J, Moritz G, et al. Psychiatric risk factors for adolescent suicide: a case control study. J Am Acad Child Adolesc Psychiatry 1993; 32: 521–9
Shafii M, Steltz-Lenarsky J, Derrick AM, et al. Comorbidity of mental disorders in the post-mortem diagnosis of completed suicide in children and adolescents. J Affect Disord 1988; 15: 277–83
Marttunen M, Aro H, Henriksson M, et al. Mental disorder in adolescent suicide: DSM-III-R axes I and II among 13 to 19 year olds in Finland. Arch Gen Psychiatry 1991; 48: 834–9
Rich CL, Young D, Fowler RC. San Diego suicide study I: young vs old subjects. Arch Gen Psychiatry 1986; 43: 577–82
De Wilde EJ. Adolescent suicidal behaviour: a general population perspective. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 249–73
Lewinsohn PM, Rohde P, Seeley JR. Treatment of adolescent depression: frequency of services and impact on functioning in young adulthood. Depress Anxiety 1998; 7: 47–52
Flament MF, Cohen D, Choquet M, et al. Phenomenology, psychosocial correlates and treatment seeking in major depression and dysthymia of adolescence. J Am Acad Child Adolesc Psychiatry 2001; 40: 1070–8
Shaffer D, Gould MS, Fisher P, et al. Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry 1996; 53: 339–48
Appleby L, Cooper J, Amos T, et al. Psychological autopsy of suicides by people under 35. Br J Psychiatry 1999; 175: 168–74
Shaffer D, Fisher P. The epidemiology of suicide in children and adolescents. J Am Acad Child Adolesc Psychiatry 1981; 20: 545–65
Shaffer D. Suicide in childhood and adolescence. J Child Psychol Psychiatry 1974; 15: 275–91
Aro H, Marttunen M, Lönnqvist J. Adolescent development and youth suicide. Suicide Life Threat Behav 1993; 23: 359–65
Brent DA, Moritz G. Developmental pathways to adolescent suicide. In: Cicchetti D, Toth SL, editors. Adolescence: opportunities and challenges. Rochester symposium on developmental psychopathology. Vol. 7. New York: University of Rochester Press, 1996: 233–58.
Angold A, Costello EJ, Worthman CM. Puberty and depression: the roles of age, pubertal status and pubertal timing. Psychol Med 1998; 28: 51–61
Cicchetti D, Toth SL. The development of depression in children and adolescents. Am Psychol 1998; 53: 221–41
Harrington R, Rutter M, Fombonne E. Developmental pathways in depression: multiple meanings, antecedents and endpoints. Dev Psychopathol 1996; 8: 601–16
Rao U, Weissman MM, Martin JA, et al. Childhood depression and risk of suicide: a preliminary report of a longitudinal study. J Am Acad Child Adolesc Psychiatry 1993; 32: 21–7
Fergusson DM, Woodward LJ, Horwood LJ. Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychol Med 2000; 30: 23–39
Deavoll BJ, Mulder RT, Beautrais AL, et al. One hundred years of suicide in New Zealand. Acta Psychiatr Scand 1993; 87: 81–5
Hider P. Youth suicide prevention by primary healthcare professionals: a critical appraisal of the literature. NZHTA report. Christchurch: Christchurch School of Medicine, 1998: 4
Värnik A. Suicide in Estonia. Acta Psychiatr Scand 1991; 84: 229–32
Allebeck P, Brandt L, Nordström P, et al. Are suicide trends among the young reversing: age, period and cohort analyses of suicide rates in Sweden. Acta Psychiatr Scand 1996; 93: 3–48
American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with suicidal behavior. J Am Acad Child Adolesc Psychiatry 2001; 40Suppl. 7: 24–51S
Brent DA, Baugher M, Bridge J, et al. Age- and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatry 1999; 38: 1497–505
Lönnqvist J. Suicide mortality in Finland declined by 21% from 1990 to 1998 [editorial]. Psychiatr Fenn 2000; 31:5
Gould MS, Kramer RA. Youth suicide prevention. Suicide Life Threat Behav 2001; 31Suppl. 1: 6–31
Cheng ATA, Lee C-S. Suicide in Asia and the Far East. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 29–48
Pritchard C. Suicide in the People’s Republic of China categorized by age and gender: evidence of the influence of culture on suicide. Acta Psychiatr Scand 1996; 93: 362–7
Värnik A, Wasserman D. Suicides in the former Soviet republics. Acta Psychiatr Scand 1992; 86: 76–8
Ramstedt M. Alcohol and suicide in 14 European countries. Addiction 2001; 96Suppl. 1: S59–75
Cantor CH. Suicide in the western world. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 9–28
Hawton K, Appleby L, Platt S, et al. The psychological autopsy approach to studying suicide: a review of methodological issues. J Affect Disord 1998; 50: 269–76
Marttunen M, Aro H, Lönnqvist J. Research on mental disorders in adolescent suicide. In: Crepet P, Ferrari G, Platt S, et al., editors. Suicidal behaviour in Europe: recent research findings. Rome: John Libbey CIC, 1992: 253–9
Kelly TM, Mann JJ. Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis. Acta Psychiatr Scand 1996; 94: 337–43
Gould MS, Shaffer D, Fisher P, et al. The clinical prediction of suicide. In: Maris RW, Berman AL, Maltsberger JT, et al., editors. Assessment and prediction of suicide. New York: Guilford, 1992: 130–43
Brent DA. Risk factors for adolescent suicide and suicidal behavior: mental and substance abuse disorders, family environmental factors, and life stress. Suicide Life Threat Behav 1995; 25: 52–63
Brent DA, Perper JA, Goldstein CE, et al. Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients. Arch Gen Psychiatry 1988; 45: 581–8
Shafii M, Carrigan S, Whittinghill JR, et al. Psychological autopsy of completed suicide in children and adolescents. Am J Psychiatry 1985; 142: 1061–4
Brent DA, Perper JA, Moritz G, et al. Familial risk factors for adolescent suicide: a case-control study. Acta Psychiatr Scand 1994; 89: 52–8
Apter A, Bleich A, King RA, et al. Death without warning: a clinical postmortem study of suicide in 43 Israeli adolescent males. Arch Gen Psychiatry 1993; 50: 138–42
Nylander I. A 20-year prospective follow-up study of 2164 cases in the child-guidance clinics in Stockholm. Acta Paediatr Scand 1979; Suppl. 276: 179–276
de Chateau Pu P. Mortality and aggressiveness in a 30-year follow-up study in child guidance clinics in Stockholm. Acta Psychiatr Scand 1990; 82: 472–6
Rydelius P-A. Deaths among child and adolescent psychiatric patients. Acta Psychiatr Scand 1984; 70: 119–26
Enqvist U, Rydelius P-A. Hur går det för barnoch ungdomspsykiatrins patienter. Samverkan krävs mellan pediatrik, barnoch vuxen psykiatri. Läkartidningen 2000; 97: 2856–61
Pelkonen M, Marttunen M, Pulkkinen E, et al. Excess mortality among former adolescent male outpatients. Acta Psychiatr Scand 1996; 94: 60–6
Gould MS, Fisher P, Parides M, et al. Psychosocial risk factors of child and adolescent completed suicide. Arch Gen Psychiatry 1996; 53: 1155–62
Groholt B, Ekeberg O, Wichstom L, et al. Youth suicide in Norway, 1990–1992: a comparison between children and adolescents completing suicide and age- and gender-matched controls. Suicide Life Threat Behav 1997; 27: 250–63
Brent DA, Bridge J, Johnson BA, et al. Suicidal behavior runs in families: a controlled family study of adolescent suicide victims. Arch Gen Psychiatry 1996; 53: 1145–52
Marttunen M, Aro H, Henriksson M, et al. Antisocial behaviour in adolescent suicide. Acta Psychiatr Scand 1994; 89: 167–73
Lesage AD, Boyer R, Grunberg F, et al. Suicide and mental disorders: a case-control study of young men. Am J Psychiatry 1994; 151: 1063–8
Marttunen M, Pelkonen M. Psychiatric risk factors for adolescent suicide: a review. Psychiatr Fenn 2000; 31: 110–25
Marttunen M, Henriksson M, Aro H, et al. Suicide among female adolescents: characteristics and comparison with males in the age group 13 to 22 years. J Am Acad Child Adolesc Psychiatry 1995; 34: 1297–307
Pirkola SP, Marttunen MJ, Henriksoon MM, et al. Alcohol-related problems among adolescent suicides in Finland. Alcohol Alcohol 1999; 34: 320–9
Isometsä E, Henriksson M, Marttunen M, et al. Mental disorders in young adult and middle-aged men who commit suicide. BMJ 1995; 310: 1366–7
Runeson B. Mental disorders in youth suicide: DSM-III-R axes I and II. Acta Psychiatr Scand 1989; 79: 490–7
Renaud J, Brent DA, Birmaher B, et al. Suicide in adolescents with disruptive disorders. J Am Acad Child Adolesc Psychiatry 1999; 38: 846–51
Thompson TR. Childhood and adolescent suicide in Manitoba: a demographic study. Can J Psychiatry 1986; 32: 264–9
Runeson B. Psychoactive substance use disorder in youth suicide. Alcohol Alcohol 1990; 25: 561–8
Marttunen M, Aro H, Lönnqvist J. Adolescent suicide: endpoint of long-term difficulties. J Am Acad Child Adolesc Psychiatry 1992; 31: 649–54
Nylander I, Hellström LH, Möllerström K. Mortality among boys reported to the Stockholm child and youth welfare committee. Acta Paedopsychiatr 1966; 33: 315–21
Pelkonen M. Inpatient psychiatric adolescents function better than expected after discharge: a follow-up study. Acta Psychiatr Scand 1990; 81: 317–21
Welner A, Welner Z, Fishman R. Psychiatric adolescent inpatients: eight- to ten-year follow-up. Arch Gen Psychiatry 1979; 36: 698–700
Goldacre M, Hawton K. Repetition of self-poisoning and subsequent death in adolescents who take overdoses. Br J Psychiatry 1985; 146: 395–8
Otto U. Suicidal acts by children and adolescents: a follow-up study. Acta Psychiatr Scand Suppl 1972; 233: 7–123
Rorsman B. Mortality among psychiatric patients. Acta Psychiatr Scand 1974; 50: 354–75
Motto JA. Suicide in male adolescents. In: Sudak HS, Ford AB, Rushforth NB, editors. Suicide in the young. Boston (MA): John Wright, 1984: 227–44
Kuperman S, Black DW, Burns TL. Excess mortality among formerly hospitalized child psychiatric patients. Arch Gen Psychiatry 1988; 45: 277–82
Larsen FW. A 30-year follow-up study of a child psychiatric clientele: II, psychiatric morbidity. Acta Psychiatr Scand 1991; 84: 65–71
Kjelsberg E, Neegaard E, Dahl AA. Suicide in adolescent psychiatric inpatients: incidence and predictive factors. Acta Psychiatr Scand 1994; 89: 235–41
Kjelsberg E, Sandvik L, Dahl AA. A long-term follow-up study of adolescent psychiatric inpatients: Part I, predictors of early death. Acta Psychiatr Scand 1999; 99: 231–6
Sellar C, Hawton K, Goldacre M. Self-poisoning in adolescents: hospital admissions and deaths in the Oxford region 1980–85. Br J Psychiatry 1990; 156: 866–70
Kotila L, Lönnqvist J. Suicide and violent death among adolescent suicide attempters. Acta Psychiatr Scand 1989; 79: 453–9
Hawton K, Fagg J, Platt S, et al. Factors associated with suicide after parasuicide in young people. BMJ 1993; 306: 1641–4
Granboulan V, Rabain D, Basquin M. The outcome of adolescent suicide attempts. Acta Psychiatr Scand 1995; 91: 265–70
Laurent A, Foussard N, David M, et al. A 5-year follow-up study of suicide attempts among French adolescents. J Adolesc Health 1998; 22: 424–30
Allebeck P, Allgulander C, Fisher LD. Predictors of completed suicide in a cohort of 50465 young men: role of personality and deviant behaviour. BMJ 1988; 297: 176–8
Groholt B, Ekeberg O, Wichstom L, et al. Suicide among children and younger and older adolescents in Norway: a comparative study. J Am Acad Child Adolesc Psychiatry 1998; 37: 473–81
Beautrais AL. Risk factors for suicide and attempted suicide among young people. In: National Youth Suicide Prevention Strategy: setting the evidence-based research agenda for Australia. Canberra: Department of Health and Aged Care, Commonwealth of Australia, 1999: 113–278
Schmidtke A, Bille-Brahe U, DeLeo D, et al. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand 1996; 93: 327–38
Joffe RT, Offord DR, Boyle MH. Ontario Child Health Study: suicidal behavior in youth age 12–16 years. Am J Psychiatry 1988; 145: 1420–3
Reinherz HZ, Giaconia RM, Silverman AB, et al. Early psychosocial risks for adolescent suicidal ideation and attempts. J Am Acad Child Adolesc Psychiatry 1995; 34: 599–611
Fergusson DM, Lynskey MT. Childhood circumstances, adolescent adjustment and suicide attempts in a New Zealand birth cohort. J Am Acad Child Adolesc Psychiatry 1995; 34: 612–22
Beautrais AL, Joyce PR, Mulder RT. Risk factors for serious suicide attempts among youths aged 13 through 24 years. J Am Acad Child Adolesc Psychiatry 1996; 35: 1174–82
Beautrais AL, Joyce PR, Mulder RT. Youth suicide attempts: a social and demographic profile. Aust N Z J Psychiatry 1998; 32: 349–57
Wichstrom L. Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents. J Am Acad Child Adolesc Psychiatry 2000; 39: 603–10
Lewinsohn PM, Rohde P, Seeley JR. Psychosocial risk factors for future adolescent suicide attempts. J Consult Clin Psychol 1994; 62: 297–305
Potter LB, Kresnow M, Powell KE, et al. The influence of geographic mobility on nearly lethal suicide attempts. Suicide Life Threat Behav 2001; 32(1 Suppl.): 42–8
Garnefski N, Arends E. Sexual abuse and adolescent maladjustment: difference between male and female victims. J Adolesc 1998; 21: 99–107
Gould MS, King R, Greenwald S, et al. Psychopathology associated with suicidal ideation and attempts among children and adolescents. J Am Acad Child Adolesc Psychiatry 1998; 37: 915–23
Kingsbury S, Hawton K, Steinhardt K, et al. Do adolescents who take overdoses have specific psychological characteristics: a comparative study with psychiatric and community controls. J Am Acad Child Adolesc Psychiatry 1999; 38: 1125–31
Groholt B, Ekeberg O, Wichstrom L, et al. Young suicide attempters: a comparison between a clinical and an epidemiological sample. J Am Acad Child Adolesc Psychiatry 2000; 39: 868–75
Pelkonen M, Marttunen M, Pulkinen E, et al. Characteristics of outpatient adolescents with suicidal tendencies. Acta Psychiatr Scand 1997; 95: 100–7
Patton G, Burns J. Preventive interventions for youth suicide: a risk factor-based approach. In: National Youth Suicide Prevention Strategy: setting the evidence-based research agenda for Australia. Canberra: Department of Health and Aged Care, 1999: 279–391
WHO. Preventing suicide. A resource for general physicians: mental and behavioural disorders. Geneva: Department of Mental Health, World Health Organization, 2000
Taylor SJ, Kingdom D, Jenkins R. How are nations trying to prevent suicide: an analysis of national suicide prevention strategies. Acta Psychiatr Scand 1997; 95: 457–63
Upanne M, Hakanen J, Rautava M. Can suicide be prevented: the suicide project in Finland 1992–1996. Goals, implementation and evaluation. Saarijärvi: National Research and Development Centre for Welfare and Health, 1999
Jenkins R, Singh B. General population strategies of suicide prevention. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 597–615
King KA. Developing a comprehensive school suicide prevention program. J Sch Health 2001; 71: 132–7
Berman AL, Jobes DA. Suicide prevention in adolescents (age 12–18). Suicide Life Threat Behav 1995; 25: 143–54
Vieland V, Whittle B, Garland A, et al. The impact of curriculum-based suicide prevention programs for teenagers: an 18-month follow-up. J Am Acad Child Adolesc Psychiatry 1991; 30: 811–5
Shaffer D, Craft L. Methods of adolescent suicide prevention. J Clin Psychiatry 1999; 60Suppl. 2: 70–4
Shaffer D, Vieland V, Garland A, et al. Adolescent suicide attempters: response to suicide-prevention programs. JAMA 1990; 264: 3151–5
Offer D, Howard KI, Schonert KA, et al. To whom do adolescents turn for help: differences between disturbed and nondisturbed adolescents. J Am Acad Child Adolesc Psychiatry 1991; 30: 623–30
Johnson GR, Krug EG, Potter LB. Suicide among adolescents and young adults: a cross-national comparison of 34 countries. Suicide Life Threat Behav 2000; 30: 74–82
Brent DA. Correlates of the medical lethality of suicide attempts in children and adolescents. J Am Acad Child Adolesc Psychiatry 1987; 26: 87–9
Carrington PJ, Moyer S. Gun control and suicide in Ontario. Am J Psychiatry 1994; 151: 606–8
Rich CL, Young JG, Fowler RC, et al. Guns and suicide: possible effects of some specific legislation. Am J Psychiatry 1990; 147: 342–6
Kruesi MJ, Grossman J, Pennington JM, et al. Suicide and violence prevention: parent education in the emergency department. J Am Acad Child Adolesc Psychiatry 1999; 38: 250–5
Gunnell D, Murray V, Hawton K. Use of paracetamol (acetaminophen) for suicide and nonfatal poisoning: worldwide patterns of use and misuse. Suicide Life Threat Behav 2000; 30: 313–26
Ohberg A, Lonnqvist J, Sarna S, et al. Violent methods associated with high suicide mortality among the young. J Am Acad Child Adolesc Psychiatry 1996; 35: 144–53
Beautrais AL. Methods of youth suicide in New Zealand: trends and implications for prevention. Aust N Z J Psychiatry 2000; 34: 413–9
Gould MS, Wallenstein S, Kleinman M, et al. Suicide clusters: an examination of age-specific effects. Am J Public Health 1990; 80: 211–2
Poijula S, Walhberg K-E, Dyregrov A. Adolescent suicide and suicide contagion in three secondary schools. Int J Emerg Ment Health 2001; 3: 169–75
Appleby L, Amos T, Doyle U, et al. General practitioners and young suicides: a preventive role for primary care. Br J Psychiatry 1996; 168: 330–3
Isometsä E, Heikkinen M, Marttunen M, et al. The last appointment before suicide: is suicidal intent communicated. Am J Psychiatry 1995; 152: 919–22
Barnes LS, Ikeda RM, Kresnow M. Help-seeking behavior prior to nearly lethal suicide attempts. Suicide Life Threat Behav 2001; 32(1 Suppl.): 68–75
Jacobsen LK, Rabinowitz I, Popper MS, et al. Interviewing prepubertal children about suicidal ideation and behavior. J Am Acad Child Adolesc Psychiatry 1994; 33: 439–52
Mishara BL. Conceptions of death and suicide in children ages 6–12 and their implications for suicide prevention. Suicide Life Threat Behav 1999; 29: 105–18
Reynolds WM. A school-based procedure for the identification of adolescents at risk for suicidal behaviors. Fam Community Health 1991; 14: 64–75
Thompson EA, Eggert LL. Using the suicide risk screen to identify suicidal adolescents among potential high school dropouts. J Am Acad Child Adolesc Psychiatry 1999; 38: 1506–14
Shaffer D, Craft L. Methods of adolescent suicide prevention. J Clin Psychiatry 1999; 60Suppl. 2: 70–4
Birmaher B, Ryan ND, Williamson DE, et al. Childhood and adolescent depression: a review of the past 10 years: part II. J Am Acad Child Adolesc Psychiatry 1996; 35: 1575–83
American Academy of Child and Adolescent Psychiatry. Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 1998; 37Suppl. 10: 63–83S
Harrington R, Whittaker J, Shoebridge P. Psychological treatment of depression in children and adolescents: a review of treatment research. Br J Psychiatry 1998; 173: 291–8
Lewinsohn PM, Clarke GN, Hops H, et al. Cognitive-behavioral treatment for depressed adolescents. Behav Ther 1990; 21: 385–401
Reed MK. Social skills training to reduce depression in adolescents. Adolescence 1994; 29: 293–302
Vostanis P, Harrington R. Cognitive-behavioural treatment of depressive disorder in child psychiatric patients: rationale and description of treatment package. Eur Child Adolesc Psychiatry 1994; 3: 111–23
Wood A, Harrington R, Moore A. Controlled trial of a brief cognitive-behavioural intervention in adolescent patients with depressive disorders. J Child Psychol Psychiatry 1996; 37: 737–46
Brent DA, Holder D, Kolko D, et al. A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive therapy. Arch Gen Psychiatry 1997; 54: 877–85
Clarke GN, Rohde P, Lewinsohn PM, et al. Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. J Am Acad Child Adolesc Psychiatry 1999; 38: 272–9
Mufson L, Weissman MM, Moreau D, et al. Efficacy of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry 1999; 56: 573–9
Rossello J, Bernai G. The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. J Consult Clin Psychol 1999; 67: 734–45
Fine S, Forth A, Gilbert M, et al. Group therapy for adolescent depressive disorder: a comparison of social skills and therapeutic support. J Am Acad Child Adolesc Psychiatry 1991; 30: 79–85
Target M, Fonagy P. Efficacy of psychoanalysis for children with emotional disorders. J Am Acad Child Adolesc Psychiatry 1994; 33: 361–71
Hazell P, O’Connell D, Heathcote D, et al. Tricyclic drugs for depression in children and adolescents [review]. Available in The Cochrane Library [database on CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 1. Oxford: Update Software, 2001
Renaud J, Axelson D, Birmaher B. A risk-benefit assessment of pharmacotherapies for clinical depression in children and adolescents. Drug Saf 1999; 20: 59–75
Simeon J, Dinicola V, Ferguson H, et al. Adolescent depression: a placebo controlled fluoxetine treatment study and follow-up. Prog Neuropsychopharmacol Biol Psychiatry 1990; 14: 791–5
Emslie GJ, Rush J, Weinberg WA, et al. A double-blind randomized placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry 1997; 54: 1031–7
Keller MB, Ryan ND, Strober M, et al. Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 2001; 40: 762–72
Mandoki MW, Tapia MR, Tapia MA, et al. Venlafaxine in the treatment of children and adolescents with major depression. Psychopharmacol Bull 1997; 33: 149–54
Findling RL, Reed MD, Blumer JL. Pharmacological treatment of depression in children and adolescents. Paediatr Drugs 1999; 1: 161–82
Strober M, DeAntonio M, Schmidt-Lackner S, et al. The pharmacotherapy of depressive illness in adolescents: an open-label comparison of fluoxetine with Imipraminetreated historical controls. J Clin Psychiatry 1999; 60: 164–9
Geller B, Luby J. Child and adolescent bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 1997; 36: 1168–76
Geller B, Cooper TB, Sun K. Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry 1998; 37: 171–8
Rey JM, Walter G. Half a century of ECT use in young people: a review. Am J Psychiatry 1997; 154: 595–602
Harrington R, Whittaker J, Shoebridge P, et al. Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. BMJ 1998; 316: 1559–63
Reinecke MA, Ryan NE, DuBois DL. Cognitive-behavioral therapy of depression and depressive symptoms during adolescence: a review and meta-analysis. J Am Acad Child Adolesc Psychiatry 1998; 37: 26–34
Hulten A, Wasserman D. Lack of continuity: a problem in the care of young suicides. Acta Psychiatr Scand 1998; 97: 326–33
Lewinsohn P, Rohde P, Seeley JR. Psychosocial characteristics of adolescents with a history of suicide attempt. J Am Acad Child Adolesc Psychiatry 1993; 32: 60–8
Marttunen M, Aro H, Lönnqvist J. Adolescence and suicide: a review of psychological autopsy studies. Eur J Child Adolesc Psychiatry 1993; 2: 10–8
Piacentini J, Rotheram-Borus MJ, Gillis JR, et al. Demographic predictors of treatment attendance among adolescent suicide attempters. J Consult Clin Psychol 1995; 63: 469–73
Pelkonen M, Marttunen M, Laippala P, et al. Factors associated with early dropout from adolescent psychiatric outpatient treatment. J Am Acad Child Adolesc Psychiatry 2000; 39: 329–36
Granboulan V, Roudot-Thoraval F, Lemerle S, et al. Predictive factors of post-discharge follow-up care among adolescent suicide attempters. Acta Psychiatr Scand 2001; 104: 31–6
Hawton K, Townsend E, Arensman E, et al. Psychosocial and pharmacological treatments for deliberate self harm. Available in the Cochrane Library [database on CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 1. Oxford: Update Software, 2001
Miller AL, Rathus JH, Linehan MM, et al. Dialectical behavior therapy adapted for suicidal adolescents. J Pract Psychiatry Behav Health 1997; 3: 78–86
Deykin EY, Hsieh C-C, Joshi N, et al. Adolescent suicidal and self-destructive behavior: results of an intervention study. J Adolesc Health Care 1986; 7:88–95
Lerner MS, Clum GA. Treatment of suicide ideators: a problem-solving approach. Behav Ther 1990; 21: 403–11
Cotgrove AJ, Zirinsky L, Black D, et al. Secondary prevention of attempted suicide in adolescence. J Adolesc 1995; 18: 569–77
Donaldson D, Spirito A, Arrigan M, et al. Structured disposition planning for adolescent suicide attempters in a general hospital: preliminary findings on short-term outcome. Arch Suicide Res 1997; 3: 271–82
Spirito A, Boergers J, Donaldson D, et al. An intervention trial to improve adherence to community treatment by adolescents after a suicide attempt. J Am Acad Child Adolesc Psychiatry 2002; 41: 435–42
Harrington R, Kerfoot M, Dyer E, et al. Randomized trial of a home-based family intervention for children who have deliberately poisoned themselves. J Am Acad Child Adolesc Psychiatry 1998; 37: 512–8
Rotheram-Borus MJ, Piacentini J, Cantwell C, et al. The 18-month impact of an emergency room intervention for adolescent female suicide attempters. J Consult Clin Psychol 2000; 68: 1081–93
Wood A, Trainor G, Rothwell J, et al. Randomised trial of group therapy for repeated deliberate self-harm in adolescents. J Am Acad Child Adolesc Psychiatry 2001; 40: 1246–53
Mann JJ. The neurobiology of suicide. Nat Med 1998; 4: 25–30
Mann JJ, Underwood MD, Arango V. Postmortem studies of suicide victims. In: SJ Watson, editor. Biology of schizophrenia and affective disease. Washington, DC: American Psychiatric Press Inc, 1996: 197–220
Mann JJ, Stoff DM. A synthesis of current findings regarding neurobiological correlates and treatment of suicidal behavior. Ann N Y Acad Sci 1997; 836: 352–63
Verkes RJ, van der Mast RC, Hengeveld MW, et al. Reduction by paroxetine of suicidal behavior in patients with repeated suicide attempts but not major depression. Am J Psychiatry 1998; 155: 543–7
Montgomery SA, Roy D, Montgomery DB. The prevention of recurrent suicidal acts. Br J Clin Pharmacol 1983; 15: 183–188S
Tondo L, Hennen J, Baldessarini RJ. Lower suicide risk with long-term lithium treatment in major affective illness: a meta-analysis. Acta Psychiatr Scand 2001; 104: 163–72
Poijula S, Dyregrov A, Wahlberg KE, et al. Reactions to adolescent suicide and crisis intervention in three secondary schools. Int J Emerg Ment Health 2001; 3: 97–106
Brent DA, Perper JA, Moritz G, et al. Major depression or uncomplicated bereavement: a follow-up of youth exposed to suicide. J Am Acad Child Adolesc Psychiatry 1994; 33: 231–9
Brent DA, Moritz G, Bridge J, et al. Long-term impact of exposure to suicide: a three-year controlled follow-up. J Am Acad Child Adolesc Psychiatry 1996; 35: 646–5
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Preparation of this manuscript was supported by the Yrjö Jahnsson Foundation and Peijas Hospital. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.
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Pelkonen, M., Marttunen, M. Child and Adolescent Suicide. Pediatr-Drugs 5, 243–265 (2003). https://doi.org/10.2165/00128072-200305040-00004
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DOI: https://doi.org/10.2165/00128072-200305040-00004