Suicide/Suicidai Behavior Health Article

Suicide/Suicidai Behavior

Alternative terms: Deliberate self-harm

The phenomenon of deliberate self-harm, often with a wish to die.

Suicide is the third leading cause of death among adolescents, occurring at a rate of 10.8 per 100,000 among 15-19 year olds in 1992. Suicide is much less common among 10-14 year olds, at 1.7 per 100,000, although the rate of suicide has increased dramatically since 1950 among all age groups. Suicide attempts are much more common, occurring in 2% of adolescent girls and 1% of adolescent boys per year. Significant suicidal ideation (with a plan to commit suicide or intent to die) is more common, occurring in 5-10% of child and adolescent youth.

The suicide completion rate is about four times higher in males than females, while the rate of attempt is two to three times higher in females than males. Completed suicide may be greater among males because of their tendency to utilize methods of more potential lethality. The rate of suicide also varies according to victims' race. Highest are Native Americans and whites. The suicide rate among African American males increased dramatically in the 1980s, and now approaches 80% of the white male suicide rate.

In the United States, the most common method for completed suicide is firearms, followed by hanging, carbon monoxide, and jumping. A gun in the house, particularly a loaded gun, appears to increase the risk for completed suicide, even in those youth without other obvious risk factors for suicide. Among suicide attempters, the two most common methods are overdose and wristcutting.

The most common precipitants for suicidal behavior among children and adolescents involve interpersonal conflict or loss, most frequently with parents or romantic attachment figures. Family discord, physical or sexual abuse, and an upcoming legal or disciplinary crisis are also commonly associated with completed and attempted suicide. Adolescents who complete suicide show relatively high suicidal intent (wish to die), although many are intoxicated at the time of death. The most serious suicide attempters leave suicide notes, show evidence of planning, and use an irreversible method. Most adolescent suicide attempts, though, are of relatively low intent and lethality, and only a minority actually want to die. Usually, suicide attempters want to escape psychological pain or unbearable circumstances, gain attention, influence others, or communicate strong feelings, such as anger or love.