Socio Environmental:

• Few differences in SES from general population, except among blacks. Black suicides tend to have higher SES than general black population.
• Suicides less likely to attend college than same-age, same-sex general population.
• Firearm ownership: conflicting evidence if same or higher in suicides than general population.

 Families:

• Youngsters who commit suicide are somewhat more likely to come from a "broken" home than are other youngsters of the same ethnic group but about half lived with both biological parents at the time of the death.
• No strong relationship to marital disharmony.
• No strong relationship to parent-child friction.
• Significant excess of poor parent-child communication in suicides.
• A high proportion of suicides and attempters have had a close family member (sibling, parent, aunt, uncle, or grandparent) or friend who attempted or committed suicide.
• Familial suicide could be a function of imitation or genetics. If it is a genetic influence we do not know if it is underlying personality or predisposition to mental illness that is inherited.

Perinatal Hazard:

• SALK, et al. (1985) noted an excess of obstetric complications among suicides.
• Mothers of the potential suicides received less prenatal care and were more likely to smoke cigarettes and take alcohol during pregnancy.
• Excess of suicide could, therefore, be due to CNS consequences of birth complications, exposure to some teratogen during pregnancy, the heritability of psychopathology, the effects of inappropriate parenting by deviant mothers, etc.

Sexual Orientation:

Male homosexuality may increase risk for suicide attempts, but not for completed suicide.

	Males				Females
	Completers		Controls		Completers		Controls
Informants	All	P	P		All	P	P
(N)	(94)	(81)	(115)		(25)	(19)	(29)
Substance or Alcohol Abuse	42%	25%	4 %		12%	--	3%
Any Disruptive	54%	31%	12%		36%	11%	7%
Any Anxiety	27%	24%	9%		28%	16%	21%
Any Mood	60%	38%	5%		68%	47%	3%
Schizophrenia	3%	1%	--		4%	--	--
Any Diagnosis	90%	59%	23%		92%	58%	24%
						Scaffer et. al. (1996)

Diagnosis in Completed Suicides

(see Table 1)

• Psychiatric diagnoses are present in about 90% of suicides.
• Alcohol and cocaine abuse is present in approximately 2/3 of 18- to 19-year-old males, but is not common in younger male (&endash; 14 years) or female suicides.
• Depression alone or in combination with aggressive behavior and/or substance abuse or anxiety is found in over half of all suicides.
• Aggressive/impulsive behavior is common in both sexes.
• Only a small number of suicides occur in schizophrenic or manic-depressive teenagers.
• Approximately a third of teenage suicide victims have made a previous suicide attempt.
• About half of the teenagers who commit suicide had had previous contact with a mental health professional.
  

Neurochemical Abnormalities:

Findings in adult and older adolescent suicide and suicide attempts include abnormally low levels of the serotonin metabolite 5HIAA; reduction in presynaptic 5HT receptor density; increase in post-synaptic 5HT receptor density. These findings have not been noted in younger teens.

Imitative Suicide:

Evidence:

• After a film or news story on suicide, suicide rates tend to go up.
• There are accounts of specific suicides that were committed shortly after seeing or reading about a suicide.
• Suicide clusters appear to depend on imitation.
  

AFSP would like to thank Columbia College of Physicians and Surgeons' Department of Child Psychiatry for allowing the use of their material on its Web site. AFSP particularly wishes to thank David Shaffer, M.D.,F.R.C.P., F.R.C. Psych, Madelyn Gould, Ph.D., Robin Garfinkel, Ph.D., Laura Mufson, Ph.D., Prudence Fisher, M.S., Holly Wilcox, M.A., and Roger Hicks, B.A., for the information within.