Lifetime prevalence of suicidal and self-injurious behaviors in a representative cohort of Slovenian adolescents with type 1 diabetes.

OBJECTIVE

To determine lifetime prevalence of suicidal and self-injurious behaviors in Slovenian adolescents with type 1 diabetes compared with healthy controls.

RESEARCH DESIGN AND METHODS

Adolescents (14-19 yr) with type 1 diabetes were compared with a normative control group of healthy secondary school students by means of a self-reported questionnaire (according to Kienhorst) containing questions on demographic and family characteristics, suicidal ideation, intended suicide, attempted suicide, possible future suicide, and self-injurious behavior. Patients received the questionnaires at regular outpatient visits to the pediatric diabetes clinic, completed them in private, and returned them by mail. Questionnaires for control subjects were administered in classrooms.

RESULTS

The responses of 126 eligible patients and 499 controls were analyzed. The control group trended toward higher lifetime prevalence of all suicidal behaviors and self-injurious behavior. The lowest prevalence of all suicidal behaviors and self-injurious behavior was reported by males with diabetes. Compared with male controls, the differences were statistically significant for suicidal ideation (p < 0.05) and intended suicide (p < 0.05). Compared with females with diabetes, the differences were statistically significant for suicidal ideation (p < 0.001), intended suicide (p < 0.01), attempted suicide (p < 0.05), and self-injurious behavior (p < 0.05). Females with diabetes reported highest prevalence of all suicidal but not self-injurious behaviors. More patients than controls reported receiving counseling the year preceding the study (p < 0.001).

CONCLUSIONS

In the study, type 1 diabetes showed a protective effect for suicidal behavior in adolescent males but not in adolescent females. Professionals working with adolescents with type 1 diabetes should be alert to possible suicidality, especially among females.