Suicide Among Youth: Which Mental Disorders Are Responsible?

Researchers from the WHO in Geneva, Switzerland and from the Christchurch School of Medicine in New Zealand reviewed the English language research from 1982 to 2001 to re-examine the occurrence and distribution of mental disorders in 894 cases of completed suicides among young people worldwide. The majority of the cases (89 percent) had at least one diagnosis of a mental disorder. Mood disorders were the most frequently diagnosed (42 percent) followed by substance-related disorders (40 percent) and then disruptive disorders (20 percent).

Mood disorders include major and minor depressive disorder, dysthymia, mania, hypomania, bipolar disorder and non-specific mood disorders. Substance-related disorders include drug abuse and alcohol dependency/abuse. Disruptive disorders include conduct disorder, attention deficit disorder, oppositional disorder and identity disorder.

The cases included subjects who were under 20 years of age -- 72 percent. Twelve percent were between the ages of 20 - 29 and 15.5 percent were 15-29 years old. Studies that met the criteria for this review originated mostly from Europe and North America. Hence, caution is necessary in application of findings from that region to program development in Asian, African, South American or developing countries.

From the limited information available, lead author Alexandra Fleischmann, Ph.D., and co-authors suggest that comprehensive suicide prevention strategies for young people target mental disorders as a whole rather than just look for depression. Even though mood disorders were tied to suicide the most, these disorders were lower than expected, according to the study.

The authors add that beyond diagnosable mental disorders, other components, such as a person's predisposition, social and environmental conditions, psychosocial risk factors, and culture should be considered to prevent suicide among youth from escalating.

Article: "Completed Suicide and Psychiatric Diagnoses in Young People: A Critical Examination of the Evidence," Alexandra Fleischmann, PhD, Jose Manoel Bertolote, MD, and Myron Belfar, MD, World Health Organization; Annette Beautrais, PhD, Christchurch School of Medicine, New Zealand; American Journal of Orthopsychiatry, Vol. 75, No. 4.