Crumley F E
Department of Psychiatry, Baylor University Medical Center, Dallas, Tex.
JAMA. 1990 Jun 13;263(22):3051-6.
Evidence suggests a significant association between use of psychoactive substances among adolescents and suicidal behavior among adolescents during the past two decades. Accumulating evidence, although not unanimous, supports the hypothesis of psychoactive substance abuse among adolescents as a risk factor for a range of suicidal behavior--ideation, attempted suicide, and completed suicide. With increasing rates of psychoactive substance abuse for the adolescent population during the past 20 years, this appears to be an increasingly important factor. It is not known if the association is causal. Psychoactive substance abuse appears to be associated with a greater frequency and repetitiveness of suicide attempts, more medically lethal attempts, a measured seriousness of intention, and greater suicidal ideation. Additional data support a specific association between alcohol intoxication and suicide by firearms among adolescents. Adolescents who abuse psychoactive substances, particularly those with any type of depressive disorder, appear to be at higher risk for suicidal behavior and may need appropriate psychiatric treatment.
有证据表明，在过去二十年中，青少年使用精神活性物质与青少年自杀行为之间存在显著关联。越来越多的证据（尽管并非一致）支持青少年滥用精神活性物质是一系列自杀行为（自杀意念、自杀未遂和自杀身亡）的风险因素这一假设。在过去20年里，青少年人群中精神活性物质滥用率不断上升，这似乎是一个日益重要的因素。目前尚不清楚这种关联是否具有因果关系。精神活性物质滥用似乎与自杀未遂的频率和重复性增加、更具医学致死性的未遂行为、有分寸的自杀意图严重性以及更强的自杀意念有关。更多数据支持青少年酒精中毒与用枪支自杀之间存在特定关联。滥用精神活性物质的青少年，尤其是患有任何类型抑郁症的青少年，似乎自杀行为风险更高，可能需要适当的精神科治疗。
