Mental Health
Suicidal Behavior
Key Points
- Suicide is the third leading cause of death in males age 15 to 24 and adolescent males are four times as likely as adolescent females to die by suicide. Suicide among males represents 79% of all U.S. suicides.
- Agitation and aggression could be a sign of depression in adolescent boys, more so than in girls.
- A July 2013 study found that psychotic symptoms in adolescents are a clinical marker of high risk for suicide attempts, particularly in those with psychopathology.
- High school students who say they are gay, lesbian or bisexual, or who say they are attracted to people of the same sex or have sex with people of the same sex, are two to seven times more likely to attempt suicide.
- A recent study found that standardized screening for suicide risk in primary care can detect youth with suicidal ideation and prompt a referral to a behavioral health care center before a fatal or serious suicide attempt is made.
- The American Academy of Child and Adolescent Psychiatry (AACAP) and the American Academy of Pediatrics (AAP) Task Force on Mental Health jointly published an article, recommending that primary care providers (PCPs) complete routine behavioral screening for adolescents, as long as appropriate mental health follow-up services were available.
Questions to ask young male patients about Suicidal Behavior
Overview
Suicidal behavior includes suicide ideation, suicidal behavior, suicide attempts, and death by suicide.1
Suicidal behavior is associated with a number of risk factors and mental disorders. Suicide is the third leading cause of death in males age 15 to 24 and adolescent males are four times as likely as adolescent females to die by suicide. Suicide among males represents 79% of all U.S. suicides.2 Firearms are the most commonly used method of suicide among males (56%).3
Suicidal behavior is being recognized with increasing frequency among adolescent male patients, and it is important to recognize that agitation and aggression could be a sign of depression in adolescent boys, more so than in girls.4 NIMH supported researchers found that among adolescents who develop major depressive disorder, as many as 7 percent may die by suicide in the young adult years.5 A July 2013 study found that psychotic symptoms in adolescents are a clinical marker of high risk for suicide attempts, particularly in those with psychopathology.6
A number of evidence-based suicide prevention interventions do exist.
High school students who say they are gay, lesbian or bisexual, or who say they are attracted to people of the same sex or have sex with people of the same sex, are two to seven times more likely to attempt suicide.7 ,8 ,9 The risk appears to be highest when a teen acquires a gay identity at a young age, when there is a family conflict, if the teen has run away or been thrown out of the house, if he or she is conflicted about his or her orientation, or if he or she has not been able to disclose his or her orientation to anyone.10 The data are not as strong on suicide deaths, but there is evidence that a disproportionate degree of suicide ideation and non-fatal suicide attempts occur among LGBTQ youth.11 Practitioners should inquire about sexual orientation when seeing a depressed teen and provide support for teens who are in the process of 'coming out'.12
In a recent Korean study, it was found that the odds ratios for potential internet addiction were higher in both boys and girls who reported suicidal ideation, depressive mood, moderate or higher subjective stress, moderate or more happiness, or ever having engaged in problematic substance use. Adolescents at high risk for internet addiction had poor mental health outcomes.13
