Retrospective analysis of youth evaluated for suicide attempt or suicidal ideation in an emergency room setting.

Suicide is the third leading cause of death in adolescents and a major contributor to morbidity in this age group. The objective of this study was to look at the demographics, major stressors and factors leading to attempting suicide as well as the methods of attempted suicide in adolescents admitted to two hospitals in a medium size city. Medical records were reviewed of adolescents admitted to two area hospitals for attempted suicide between 7/1/97-12/31/99. Coroner's data on completed suicide were also reviewed. In the study period a total of 287 persons aged 21 years or under were admitted for attempted suicide. Mean age was 16.9 years (range 7-21). 53.4% of the total were females and 46.6 were males with the majority of the total being Caucasians (75.6%). Interpersonal conflicts were the most common stressors preceding the attempt; fight with parents 20%, end of a relationship 12%, fight with a significant other 8%. Financial difficulties were the culprit in 10% of the cases. Abuse was not clearly recorded in 64% of cases. In cases where documentation was clear, 60% reported sexual and 67% physical abuse. Nearly half of the patients had a prior psychiatric diagnosis with prior suicide attempt and depression being most common at 27 and 18% respectively. Overdose was the most common method utilized. There were 20 completed adolescent suicides in the area with firearms as the method used in all of them. It is concluded that suicide continues to be a major problem in adolescents. Access to guns may be a detrimental factor in completing suicide. Health care providers may help identify those at risk by routinely screening all adolescents for depression and suicide.