Shaffer D, Gould M S, Fisher P, Trautman P, Moreau D, Kleinman M, Flory M
Division of Child Psychiatry, New York (NY) State Psychiatric Institute.
Arch Gen Psychiatry. 1996 Apr;53(4):339-48. doi: 10.1001/archpsyc.1996.01830040075012.
The age, sex, and ethnic distribution of adolescents who commit suicide is significantly different from that of the general population. The present study was designed to examine psychiatric risk factors and the relationship between them and demographic variables.
A case-control, psychologic autopsy study of 120 of 170 consecutive subjects (age, <20 years) who committed suicide and 147 community age-, sex-, and ethnic-matched control subjects who had lived in the Greater New York (NY) area.
By using parent informants only, 59% of subjects who committed suicide and 23% of control subjects who met DSM-III criteria for a psychiatric diagnosis, 49% and 26%, respectively, had had symptoms for more than 3 years, and 46% and 29%, respectively, had had previous contact with a mental health professional. Best-estimate rates, based on multiple informants for these parameters, for suicides only, were 91%, 52%, and 46%, respectively. Previous attempts and mood disorder were major risks factors for both sexes; substance and/or alcohol abuse was a risk factor for males only. Mood disorder was more common in females, substance and/or alcohol abuse occurred exclusively in males (62% of 18- to 19-year-old suicides). The prevalence of a psychiatric diagnosis and, in particular, substance and/or alcohol abuse increased with age.
A limited range of diagnoses--most commonly a mood disorder alone or in combination with conduct disorder and/or substance abuse--characterizes most suicides among teenagers.
自杀青少年的年龄、性别和种族分布与普通人群有显著差异。本研究旨在调查精神风险因素及其与人口统计学变量之间的关系。
对170名连续自杀的受试者（年龄<20岁）中的120名进行病例对照心理解剖研究，并选取147名居住在大纽约地区、年龄、性别和种族匹配的社区对照受试者。
仅通过父母提供信息，自杀受试者中有59%以及符合DSM-III精神疾病诊断标准的对照受试者中有23%，分别有超过3年的症状，且分别有46%和29%曾与心理健康专业人员接触过。基于这些参数的多个信息提供者得出的最佳估计率，仅针对自杀者，分别为91%、52%和46%。既往自杀未遂和情绪障碍是男女两性的主要风险因素；物质和/或酒精滥用仅是男性的风险因素。情绪障碍在女性中更常见，物质和/或酒精滥用仅发生在男性中（18至19岁自杀者中的62%）。精神疾病诊断的患病率，尤其是物质和/或酒精滥用的患病率随年龄增加。
有限的一系列诊断——最常见的是单独的情绪障碍或与品行障碍和/或物质滥用合并——是青少年自杀的主要特征。
