Suicide and Suicide Attempts in Adolescents

Abstract

Suicide is the second leading cause of death for adolescents 15 to 19 years old. This report updates the previous statement of the American Academy of Pediatrics and is intended to assist pediatricians, in collaboration with other child and adolescent health care professionals, in the identification and management of the adolescent at risk for suicide. Suicide risk can only be reduced, not eliminated, and risk factors provide no more than guidance. Nonetheless, care for suicidal adolescents may be improved with the pediatrician’s knowledge, skill, and comfort with the topic, as well as ready access to appropriate community resources and mental health professionals.

Suicidal Ideation and Attempts Among Students in Grades 8, 10, and 12 — Utah, 2015

“…Youths with a supportive family environment had a lower risk for suicidal ideation and suicide attempts, which has been demonstrated in previous studies related to the family environment and suicidal thoughts and behaviors, where family cohesion, positive parent-child connection, time spent together, parental supervision, and high parental expectations of academics and behaviors were protective against suicidal behaviors ( 8 , 9 ). Public health professionals in Utah who are developing and implementing youth suicide prevention interventions might consider extending initiatives to the home environment to include family members and addressing protective and risk factors identified in this investigation.…”

“…Past research has demonstrated similar sex differences in nonfatal and fatal suicidal behaviors among youths. Rates of suicidal ideation and suicide attempts are higher among adolescent females in the United States, whereas rates of completed suicide are higher among adolescent males, which is in part a consequence of the choice of more lethal suicide attempt methods among males ( 1 , 8 – 10 ). …”

Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents

“…Suicide is a significant source of morbidity and mortality among adolescents [13]. Primary care is an ideal setting in which to identify and intervene with suicidal adolescents.…”

“…Suicide risk was assessed on the PSF using a single question based on American Academy of Pediatrics (AAP) and American Medical Association recommendations [10,11,13]: “Have you ever seriously thought about killing yourself, made a plan, or actually tried to kill yourself?” In addition to suicide risk, depression was also assessed as part of the PSF using the Patient Health Questionnaire-2 (PHQ-2) [20] as an initial screen. This instrument consists of two questions assessing anhedonia and depressed mood over the past 2 weeks.…”

“…The American Academy of Pediatrics and the American Medical Association recommend annual suicide screening for adolescents in primary care [10–13]. The US Preventative Services Task Force, however, concluded that there is insufficient evidence to recommend universal screening for suicide risk among asymptomatic adolescents and adults [14].…”