Teenage Suicide

Suicide is the fourth leading cause of death during the teenage years, preceded in frequency only by trauma, malignancy, and homicide.1 Recent statistics indicate that the number of suicides in adolescents has risen dramatically in the past decade, resulting in approximately 5,000 deaths per year. For youths 15 to 19 years old, the figures have actually doubled from 1968 to 1976; 11 boys per 100,000 in the population are now dying by suicide each year.2 Even among adolescents 10 to 14 years old, the trend is increasing and went from 116 to 158 deaths per year between 1968 and 1976. As distressing as these data appear, it is more alarming to realize that suicides are notoriously under-reported. Suicide affects youngsters from all races and socioeconomic groups. For every suicide completed, between 50 and 200 are attempted. Boys succeed in their suicide attempts more frequently than girls, mainly because they use more lethal methods, such as firearms or hanging. Girls generally attempt suicide by ingesting pills and are more frequently resuscitated. The pediatrician can provide a significant resource in preventing adolescent suicide by identifying youngsters at high risk and recognizing behavioral clues in youngsters contemplating suicide. CLINICAL PRESENTATIONS OF ADOLESCENTS CONTEMPLATING SUICIDE Youngsters planning suicide frequently provide behavioral clues to their intent, such as giving away prized possessions or writing notes or poems expressing death themes. If the pediatrician suspects that a teenager is contemplating suicide, he should ask the adolescent directly about suicidal thoughts. Inquiring about suicide does not cause suicide! Quite the contrary, the adolescent may be relieved that someone has heard his cry for help.