Brent D A, Baugher M, Bridge J, Chen T, Chiappetta L
Western Psychiatric Institute and Clinic, Pittsburgh.
J Am Acad Child Adolesc Psychiatry. 1999 Dec;38(12):1497-505. doi: 10.1097/00004583-199912000-00010.
To examine the impact of age and sex on adolescent suicide risk.
A standard psychological autopsy protocol was used to compare 140 suicide victims with 131 community controls. The risk factors for older (> or = 16 years) and younger, and for male and female suicide were compared.
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.
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.
探讨年龄和性别对青少年自杀风险的影响。
采用标准的心理解剖协议，将140名自杀受害者与131名社区对照者进行比较。比较了年龄较大（≥16岁）和较小青少年以及男性和女性自杀的风险因素。
情绪障碍、父母精神病理学、终身虐待史、枪支可得性和既往自杀未遂在所有4个人口统计学组中均传达了显著的自杀风险。精神病理学，特别是物质滥用（单独以及与情绪障碍共病），在年龄较大的青少年中比年龄较小的青少年更常见，且传达了更高的自杀风险。年龄较小的自杀受害者自杀意图较低。男性选择更不可逆转的方法，品行障碍在男性中既更普遍又是更显著的风险因素。
年龄较大的青少年与年龄较小的青少年相比，自杀率增加部分归因于精神病理学（即物质滥用）的更高患病率以及年龄较大人群中更高的自杀意图。男性自杀率增加较难解释，但可能源于方法选择以及品行障碍在男性中更普遍且传达了更高风险。
