Age- and sex-related risk factors for adolescent suicide

Objective: To examine the impact of age and sex on adolescent suicide risk. Method: A standard psychological autopsy protocol was used to compare 140 suicide victims with 131 community controls. The risk factors for older (greater than or equal to 16 years) and younger, and for male and female suicide were compared. Results: Mood disorders, parental psychopathology, lifetime history of abuse, availability of a gun, and past suicide attempt conveyed significant risk for suicide across all 4 demographic groups. Psychopathology, particularly substance abuse (alone and comorbid with mood disorder), was more common and conveyed a much higher risk for suicide in the older versus younger adolescents. Younger suicide victims showed lower suicidal intent. Males chose more irreversible methods, and conduct disorder was both more prevalent and a more significant risk factor in males. Conclusions: The increased rate of suicide in older versus younger adolescents is due in part to greater prevalence of psychopathology, namely substance abuse, and greater suicidal intent in the older population. The increased rate in males is less easily explained, but it may stem from method choice and the greater prevalence of and risk conveyed by conduct disorder in males.