Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
J Adolesc Health. 2023 Apr;72(4):519-525. doi: 10.1016/j.jadohealth.2022.11.009. Epub 2023 Jan 7.
Suicide is the second leading cause of death for adolescents in the United States; however, suicide is preventable and a better understanding of circumstances that contribute to death can inform prevention efforts. While the association between adolescent suicide and mental health is well established, multiple circumstances contribute to suicide risk. This study examines characteristics of adolescents who died by suicide and differences in circumstances between those with and without known mental health conditions at the time of death.
Logistic regression models were used to estimate adjusted odds ratios and 95% confidence intervals of circumstances contributing to suicide between decedents with and without known mental health conditions using data from the 2013 to 2018 National Violent Death Reporting System (analyzed in 2021).
Decedents with a known mental health condition were 1.2-1.8 times more likely to experience problematic alcohol misuse, substance misuse, family and other nonintimate relationship problems, and school problems; however, there were no significant differences between those with and without a known mental health condition for the preceding circumstances of arguments or conflicts, criminal or legal problems, or any crisis occurring within the two weeks prior to death.
A comprehensive suicide prevention approach can address not only mental health conditions as a risk factor but also life stressors and other crises experienced among adolescents without known mental health conditions.
自杀是美国青少年的第二大死因;然而,自杀是可以预防的,对导致自杀的情况有更深入的了解可以为预防工作提供信息。虽然青少年自杀与心理健康之间的联系是明确的,但多种情况会增加自杀风险。本研究调查了自杀青少年的特征,以及在死亡时是否存在已知心理健康状况的情况下,自杀风险情况的差异。
使用 2013 年至 2018 年国家暴力死亡报告系统的数据(在 2021 年进行分析),采用逻辑回归模型,估计了在存在和不存在已知心理健康状况的情况下,导致自杀的各种情况之间的调整后优势比和 95%置信区间。
有已知心理健康状况的死者经历问题性酒精滥用、物质滥用、家庭和其他非亲密关系问题以及学校问题的可能性是 1.2-1.8 倍;然而,在是否存在已知心理健康状况的情况下,在前一个时期的争吵或冲突、刑事或法律问题或死亡前两周内发生的任何危机方面,没有显著差异。
全面的自杀预防方法不仅可以解决心理健康状况作为风险因素的问题,还可以解决没有已知心理健康状况的青少年所经历的生活压力和其他危机。