Long-term impact of exposure to suicide: A three-year controlled follow-up

Objective: To determine the long-term impact of exposure to suicide on the friends of adolescent suicide victims. Method: One hundred sixty-six friends of suicide victims and unexposed community controls were followed up at periodic intervals up to 3 years after the suicide, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Epidemiologic and Present Episode versions, to assess current and incident psychopathology. Results: The incidence of suicide attempts was comparable between groups over the entire follow-up period, despite higher rates of baseline and incident psychopathology in the exposed group, An increased incidence of depression and anxiety was found in friends that was most marked in the first 6 months of follow-up. An increased incidence of posttraumatic stress disorder (PTSD) in those exposed was seen in the early as well as the later periods of follow-up. Those exposed youths who knew the suicide plans of the suicide victim were at the greatest risk for incident depression and PTSD over the entire course of follow-up. Conclusion: Exposure to suicide does not result in an increased risk of suicidal behavior among friends and acquaintances, but it has a relatively long impact in terms of increased incidence of depression, anxiety, and PTSD.