Skip to main content
Log in

Overview of early detection and treatment strategies for suicidal behavior in young people

  • Published:
Journal of Youth and Adolescence Aims and scope Submit manuscript

Abstract

Suicidal behavior represents a major public health problem requiring the development and implementation of early detection and treatment strategies. This paper integrates a proposed model of risk factors with a multithreshold level of early detection in youth suicide. These riskfactor domains include psychiatric diagnosis, personality traits, psychosocial factors, life events and chronic medical illness, biological factors, and family history and genetics. The three levels of early detection are detection awareness, major problem awareness, and major psychiatric disorders. Each of these levels are described in detail with examples, followed by a review of intervention and treatment strategies for each level. Detection awareness requires a strong component of education and public health interventions. Major problem awareness requires a level of active intervention and treatment in dealing with behavior problems, personality issues, or specific life events. The final level deals not exclusively but primarily with the treatment of psychiatric disorders since it is proposed that treatment of specific psychiatric syndromes plays a major role in preventing suicide. The primary purpose of this paper is to outline a new approach to early detection and intervention for the prevention of youth suicide.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Asberg, M. L., Traskman, L., and Thoren, P. (1976). 5-HIAA in the cerebrospinal fluid: A biochemical suicide prediction.Arch. Gen. Psychiatry 33: 1193–1197.

    PubMed  Google Scholar 

  • Barraclough, B., Bunch, J., Nelson, B., and Sainsbury, P. (1974). A hundred causes of suicide: Clinical aspects.Br. J. Psychiat. 125: 355–373.

    Google Scholar 

  • Beck, A. T., Kovacs, M., and Weissman, A. (1979). Assessment of suicidal intention: The scale for suicidal ideation.J. Consult. Clin. Psychol. 47: 343–352.

    PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., Kovacs, M., and Garrison, B. (1985). Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalized with suicidal ideation.Am. J. Psychiat. 142: 559–563.

    PubMed  Google Scholar 

  • Blumenthal, S. J. (1984, May). An overview of suicide risk factor research. Paper presented at the annual meeting of the American Psychiatric Association, Los Angeles.

  • Blumenthal, S. J., and Kupfer, D. J. (1986). Generalizable treatment strategies for suicidal behavior.Ann. NY Acad. Sci. 487: 327–340.

    PubMed  Google Scholar 

  • Boyd, J. (1983). Increase in rate of suicide by firearms.N. Engl. J. Med. 308: 872–874.

    PubMed  Google Scholar 

  • Brent, D. A., Perper, J. A., and Allman, C. J. (1987). Alcohol, firearms, and suicide among youth.JAMA 257: 3369–3372.

    PubMed  Google Scholar 

  • British Medical Journal (1981). Annotation: children and parasuicide. 283:337–338.

  • Brown, G. L., Goodwin, F. K., and Bunney, W. E. (1982). Human aggression and suicide: Their relationship to neuropsychiatric diagnosis and serotonin metabolism. In Ho, B. T., Schooler, J. C., and Usdin, E. (eds.),Serotonin in Biological Psychiatry, Raven Press, New York.

    Google Scholar 

  • Centers for Disease Control 1985 Suicide Surveillance, 1970–1980, U.S. Department of Health and Human Services Public Health Service, Atlanta, GA.

    Google Scholar 

  • Chiles, J. A., Miller, L. M., and Cox, G. B. (1980). Depression in an adolescent delinquent population.Arch. Gen. Psychiat. 37: 1179–1184.

    PubMed  Google Scholar 

  • Crumley, F. (1981). Adolescent suicide attempts and borderline personality disorder: Clinical features.Southwest Med. J. 74: 546–549.

    Google Scholar 

  • Crumley, F. E. (1982). The adolescent suicide attempt: A cardinal symptom of a serious psychiatric disorder.Am. J. Psychother. 36: 158–165.

    PubMed  Google Scholar 

  • Dorpat, T. L., and Ripley, H. S. (1960). A study of suicide in the Seattle area.Comp. Psychiat. 1: 349–359.

    Google Scholar 

  • Egeland, J. A., and Sussex, J. N. (1985). Suicide and family loading for affective disorders.JAMA 254: 915–918.

    PubMed  Google Scholar 

  • Farberow, N., and Simon, M. (1969). Suicide in Los Angeles and Vienna: An intercultural study of two cities.Public Hlth. Rep. 84: 389–403.

    Google Scholar 

  • Frances, A., and Blumenthal, S. J. (1986, May 8–9). Personality disorders and characteristics. Paper presented at the National Conference on Risk Factors for Youth Suicide, Bethesda, MD.

  • Gould, M. S., and Shaffer, D. (1986). The impact of suicide in television movies. Evidence of imitation.New. Engl. J. Med. 315: 690–694.

    PubMed  Google Scholar 

  • Haberlandt, W. (1965). Der suizid als genetisches problem (Zwillings- and familier analyse).Anthrop. Anz. 29: 65–89.

    Google Scholar 

  • Haberlandt, W. (1967). Aportacion a la genetica del suicidio.Folio. Clin. Int. 17: 319–322.

    Google Scholar 

  • Hagnell, O., and Rorsman, B. (1980). Suicide in the Lundby Study: A controlled prospective investigation of stressful life events.Neuropsychobiol. 6: 319–332.

    Google Scholar 

  • Hawton, K., and Goldacre, M. (1982). Hospital admissions for adverse effects of medicinal agents (mainly self-poisoning) among adolescents in the Oxford region.Br. J. Psychiat. 141: 166–170.

    Google Scholar 

  • Hawton, K., O'Grady, J., Osborn, M., and Cole, D. (1982). Adolescents who take overdoses: Their characteristics, problems and contacts with helping agencies.Br. J. Psychiat. 140: 118–123.

    Google Scholar 

  • Hirschfeld, R., and Blumenthal, S. (1986). Personality, life events and other psychosocial factors in adolescent depression and suicide: A review. In Klerman, G. (ed.),Suicide Among Adolescents and Young Adults, American Psychiatric Press, Washington, D.C.

    Google Scholar 

  • Hollinger, P. C., Offer, D., and Ostrov, E. (1987). Suicide and homicide in the United States: An epidemiologic study of violent death, population changes, and the potential for prediction. 144: 215–219.

    Google Scholar 

  • Horsfall, J. S. (1982). Final evaluation report. Project #615. Intervention/prevention seeking solutions to self destructive behavior in children. Barrett, T. (project director), Sopris West, Inc.

  • Jamison, K. R. (1986). Suicide and bipolar disorders.Ann. NY Acad. Sci. 487: 301–315.

    PubMed  Google Scholar 

  • Kety, S. S. (1986). Genetic factors in suicide. In Roy, A. (ed.),Suicide, Williams & Wilkins, Baltimore, MD.

    Google Scholar 

  • Linnoila, M., Virkkunen, M., Scheinin, M., Nuutila, A., Rimon, R., and Goodwin, F. K. (1983). Low cerebrospinal fluid 5-hydroxyindoleacetic acid concentration differentiates impulsive from nonimpulsive violent behavior.Life Sci. 33: 2609–2614.

    PubMed  Google Scholar 

  • Morgan, H. G. (1979).Death Wishes?: The Understanding and Management of Deliberate Self-Harm. Wiley, Chichester, England.

    Google Scholar 

  • Neuringer, C. (1974).Psychological Assessment of Suicidal Risk. Charles C. Thomas, Springfield, IL.

    Google Scholar 

  • Patsiokas, A. T., Clum, G. A., and Luscomb, R. L. (1979). Cognitive characteristics of suicide attempters.J. Consult. Clin. Psychol. 47: 478–484.

    PubMed  Google Scholar 

  • Petzel, S. V., and Riddle, M. (1981). Adolescent suicide: Psychosocial and cognitive aspects.Adoles. Psychiat. 9: 343–398.

    Google Scholar 

  • Phillips, D. P., and Carstensen, L. L. (1986). Clustering of teenage suicides after television news stories about suicide.N. Engl. J. Med. 315: 685–689.

    PubMed  Google Scholar 

  • Platt, J., and Spivack, G. (1985).Manual for the Means End Problem Solving Procedure (MEPS): A Measure of Interpersonal Problem Solving Skill. Hahnemann Medical College and Hospital, Department of Mental Health Services, Hahnemann Community MH/MR Center, Philadelphia, PA.

    Google Scholar 

  • Pokorny, A. D. (1983). Prediction of suicide in psychiatric patients: Report of a prospective study.Arch. Gen. Psychiat. 40: 249–257.

    PubMed  Google Scholar 

  • Robins, L. N. (1986). Changes in conduct disorder over time. In Farran, D. C., and McKinney, J. D. (eds.),Risk in Intellectual and Psychosocial Development, Academic Press, Inc., New York.

    Google Scholar 

  • Robins, E., Murphy, G. E., Wilkinson, R. H., Jr., Gassner, S., and Kayes, J. (1959). Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides.Am. J. Public Hlth. 49: 888–899.

    Google Scholar 

  • Roy, A. (1982). Risk factors for suicide in psychiatric patinets.Arch. Gen. Psychiat. 39: 1089–1095.

    PubMed  Google Scholar 

  • Roy, A. (1983). Family history of suicide.Arch. Gen. Psychiat. 40: 971–974.

    PubMed  Google Scholar 

  • Salk, L., Lipsitt, L. P., Stumer, W. Q., Reilly, B. M., and Levat, R. H. (1985). Relationship of maternal and perinatal conditions to eventual adolescent suicide.Lancet 1: 624–627.

    PubMed  Google Scholar 

  • Schotte, D. E., and Cum, G. A. (1982). Suicide ideation in a college population: A test of a model.J. Consult. Clin. Psychol. 50: 690–696.

    PubMed  Google Scholar 

  • Schulsinger, F., Kety, S. S., Rosenthal, D., and Wender, P. H. (1979). A family study of suicide. In Schou, M., and Strömgren, E. (eds.),Origins, Prevention and Treatment of Affective Disorders. Academic Press, Inc., New York.

    Google Scholar 

  • Sedvall, G., Fyro, B., Gullberg, B., Nyback, H., Wiesel, F. A., and Wode-Helgodt, B. (1980). Relationships in healthy volunteers between concentrations of monoamine metabolites in cerebrospinal fluid and family history of psychiatric morbidity.Br. J. Psychiat. 136: 366–374.

    Google Scholar 

  • Shaffer, D. (1974). Suicide in childhood and early adolescence.J. Child Psychol. Psychiat. 15: 275–291.

    PubMed  Google Scholar 

  • Shaffer, D., and Fisher, P. (1981). The epidemiology of suicide in children and adolescents.J. Am. Acad. Child Psychiat. 20: 545–565.

    Google Scholar 

  • Shaffer, D., Gould, M., and Traubman, P. (1985, September 18–20). Paper presented at the Conference on the Psychobiology of Suicidal Behavior, New York.

  • Shafii, M. (1986, May 8–9). Paper presented at the National Conference on Risk Factors for Youth Suicide, Bethesda, MD.

  • Shafii, M., Carrigan, S., Whittinghill, J. R., and Derrick, A. (1985). Psychological autopsy of completed suicide in children and adolescents.Am. J. Psychiat. 142: 1061–1064.

    PubMed  Google Scholar 

  • Tsuang, M. (1977). Genetic factors in suicide.Dis. Nerv. System 38: 498–501.

    Google Scholar 

  • Tsuang, M. (1983). Risk of suicide in the relatives of schizophrenics, manics, depressives and controls.J. Clin. Psychiat. 44: 396–400.

    Google Scholar 

  • van Praag, H. M., and de Haan, S. (1980). Depression vulnerability and 5HT prophylaxis.Psychiat. Res. 3: 75–83.

    Google Scholar 

  • White, H. C. (1974). Self-poisoning in adolescence.Br. J. Psychiat. 124: 24–35.

    Google Scholar 

  • Zaw, K. (1981). A suicidal family.Br. J. Psychiat. 189: 68–69.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Received M.D. from the University of Tennessee.

Received M.D. from Yale University.

Both authors are interested in treatment strategies and prevention of suicide.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blumenthal, S.J., Kupfer, D.J. Overview of early detection and treatment strategies for suicidal behavior in young people. J Youth Adolescence 17, 1–23 (1988). https://doi.org/10.1007/BF01538721

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01538721

Keywords

Navigation