Suicidal Behaviour in Children and Adolescents. Part 1: Etiology and Risk Factors

Shaffer D , Pfeffer CR , Bernet W , . Practice parameter for the assessment and treatment of children and adolescents with suicidal behaviour. J Am Acad Child Adolesc Psychiatry. 2001;40:(7 Suppl)24S–51S.

Brent DA. Depression and suicide in children and adolescents. Pediatr Rev. 1993;14:380 -388.

Harrington R , Pickles A , Aglan A , . Early adult outcomes of adolescents who deliberately poisoned themselves. J Am Acad Child Adolesc Psychiatry. 2005;45:337–345.

Statistics Canada. Suicides, and suicide rate, by sex and by age group. 2005. Available at: http://www.statcan.ca/english/Pgdb/health01.htm (accessed April 2007).

Public Health Agency of Canada. Measuring up: a health surveillance update on Canadian children and youth. Ottawa (ON): Minister of Health; 1999. Available from: http://www.phac-aspc.gc.ca/publicat/meas-haut/mu_y_e.html (accessed April 2007).

Anderson RN. Deaths: leading causes for 2000. Natl Vital Stat Rep. 2002;50:1–85.

Jeanneret O. A tentative epidemiologic approach to suicide prevention in adolescence. J Adolesc Health. 1992;13:409–414.

Metha A , Weber B , Webb LD. Youth suicide prevention: a survey and analysis of policies and efforts in the 50 states. Suicide Life Threat Behav. 1998;28:150–164.

Gould MS , Greenberg T , Velting DM , . Youth suicide risk and preventive interventions: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2003;42:386–405.

Kann L , Kinchen SA , Williams BI , . Youth risk behavior surveillance-United States, 1997. MMWR CDC Surveill Summ. 1998;47;1–89.

Brent DA , Perper JA , Allman CJ , . The presence and accessibility of firearms in the homes of adolescent suicides: a case-control study. JAMA. 1991;266:2989–2995.

Olfson M , Marcus SC , Pincus HA , . Antidepressant prescribing practices of outpatient psychiatrists. Arch Gen Psychiatry. 1998;55:310–316.

Kann L , Warren CW , Harris WA , . Youth risk behavior surveillance-United States, 1993. MMWR CDC Surveill Summ. 1995;44:1–56.

Kann L , Warren CW , Harris WA , . Youth risk behavior surveillance-United States, 1995. MMWR CDC Surveill Summ. 1996;45:1–84.

Grunbaum JA , Kann L , Kinchen SA , . Youth risk behavior surveillance-United States, 1999. MMWR CDC Surveill Summ. 2000;49:1–96.

Grunbaum JA , Kann L , Kinchen SA , . Youth risk behavior surveillance-United States, 2001. MMWR CDC Surveill Summ. 2002;51:1–64.

Cutright P , Fernquist RM. Firearms and suicide: the American experience, 1926-1996. Death Stud. 2000;24:705–719.

Simon GE , Von Korff M. Reevaluation of secular trends in depression rates. Am J Epidemiol. 1992;135:1411–1422.

Murphy JM , Laird NM , Monson RR , . A 40 year perspective on the prevalence of depression. The Stirling County Study. Arch Gen Psychiatry. 2000;57:207–215.

Kessler RC , McGonagle KA , Zhao S , . Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19.

Joyce PR. Improvements in the recognition and treatment of depression and decreasing suicide rates. N Z Med J. 2001;114:535–536.

American College of Neuropsychopharmacology (ACNP) Task Force on SSRIs and Suicidal Behavior. Executive summary: preliminary report of the Task Force on SSRIs and Suicidal Behavior in youth. January 21, 2004. Nashville (TN): ACNP; 2004. Available at: http://www.acnp.org/Docs/ACNP%20Task%20Force%20Report%20on%20SSRIs%20and%20Suicide%20in%20Youth.pdf (accessed April 2007).

Hazell P , O'Connell D , Heathcote D , . Tricyclic drugs for depression in children and adolescents. Cochrane Database Syst Rev. 2000;(3):CD002317.

Olfson M , Marcus SC , Weissman MM , . National trends in the use of psychotropic medications by children. J Am Acad Child Adolesc Psychiatry. 2002;41:514–521.

Isacsson G. Suicide prevention-a medical breakthrough? Acta Psychiatr Scand. 2000;102113–117.

Ludwig J , Marcotte DE. Anti-depressants, suicide, and drug regulation. J Policy Anal Manage. 2005;24:249–272.

Gibbons RD , Hur K , Bhaumik DK , . The relationship between antidepressant prescription rates and rate of early adolescent suicide. Am J Psychiatry. 2006;163;1898–1904.

Jick H , Kaye JA , Jick SS. Antidepressants and the risk of suicidal behaviors. JAMA. 2004;292:338–343.

Medicines and Healthcare products Regulatory Agency. Safety review of antidepressants used by children completed. [Use of selective serotonin reuptake inhibitors (SSRIs) in children and adolescent with major depressive disorder (MDD)-only fluoxetine (Prozac) shown to have a favourable balance of risks and benefits for the treatment of MDD in the under 18s.] 10 December 2003. [cited 2004 Mar 14]. Available from: http://www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&useSecondary=true&ssDocName=CON002045&ssTargetNodeId=389 (accessed April 2007).

US Food and Drug Administration. FDA Public Health Advisory. Suicidality in children and adolescents being treated with antidepressant medications. 15 October 2004 [cited 2005 Mar 5]. Available from: http://www.fda.gov/cder/drug/antidepressants/SSRIPHA200410.htm.

Health Canada. Health Canada advises Canadians under the age of 18 to consult physicians if they are being treated with newer anti-depressants. 3 February 2004. [cited 2005 Mar 5]. Available from: http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/2004/2004_02_e.html.

Bailly D. [Safety of selective serotonin reuptake inhibitor antidepressants in children and adolescents]. Presse Med. 2006;35:(10 Pt 2)1507–1515.

Jureidini JN , Doecke CJ , Mansfield PR , . Efficacy and safety of antidepressants for children and adolescents. BMJ. 2004;328:879–883.

Whittington CJ , Kendall T , Fonagy P , . Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet. 2004;363:1341–1345.

Aichhorn AW , Geretsegger C. Safety and efficacy of selective serotonin reuptake inhibitors in the treatment of children and adolescents compared to adults. Neuropsychiatrie. 2005;19:34–39.

Bridge JA , Salary CB , Birmaher B , . The risks and benefits of antidepressant treatment for youth depression. Ann Med. 2005;37:404–412.

Emslie GJ , Wagner KD , Kutcher S , . Paroxetine treatment in children and adolescents with major depressive disorder: a randomized, multicenter, double-blind, placebo-controlled trial. J Am Acad Child Adolesc Psychiatry. 2006;45:709–719.

Apter A , Lipschitz A , Fong R , . Evaluation of suicidal thoughts and behaviors in children and adolescents taking paroxetine. J Child Adolesc Psychopharmacol. 2006;16:(1-2)77–90.

Berard R , Fong R , Carpenter DJ , . An international, multicenter, placebo-controlled trial of paroxetine in adolescents with major depressive disorder. J Child Adolesc Psychopharmacol. 2006;16:(1-2)59–75.

Aursnes I , Tvete IF , Gaasemyr J , . Suicide attempts in clinical trials with paroxetine randomised against placebo. BMC Med. 2005;3:14.

von Knorring AL , Olsson GI , Thomsen PH , . A randomized, double-blind, placebo-controlled study of citalopram in adolescents with major depressive disorder. J Clin Psychopharmacol. 2006;26:311–315.

March JS , Klee BJ , Kremer CME. Treatment benefit and the risk of suicidality in multicenter, randomized, controlled trials of sertraline in children and adolescents. J Child Adolesc Psychopharmacol. 2006;16:(1-2)91–102.

Nilsson M , Joliat MJ , Miner CM , . Safety of subchronic treatment with fluoxetine for major depressive disorder in children and adolescents. J Child Adolesc Psychopharmacol. 2004;14:412–417.

Wagner KD , Jonas J , Findling RL. . A double-blind, randomized, placebo-controlled trial of escitalopram in the treatment of pediatric depression. J Am Acad Child Adolesc Psychiatry. 2006;45:280–288.

Courtney DB. Selective serotonin reuptake inhibitor and venlafaxine use in children and adolescents with major depressive disorder: a systematic review of published randomized controlled trials. Can J Psychiatry. 2004;49:557–563.

Mosholder AD , Pamer C. Postmarketing surveillance of suicidal adverse events with pediatric use of antidepressants. J Child Adolesc Psychopharmacol. 2006;16:(1-2)33–36.

Hammad TA , Laughren T , Racoosin J. Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry. 2006;63:332–339.

Sonderg L , Kvist K , Andersen PK , . Do antidepressants precipitate youth suicide?: a nationwide pharmacoepidemiological study. Eur Child Adolesc Psychiatry. 2006;15:232–240.

Wohlfarth TD , van Zwieten B , Lekkerkerker FJ , . Antidepressants use in children and adolescents and the risk of suicide. Eur Neuropsychopharmacol. 2006;16:79–83.

Andrade NN , Hishinuma ES , McDermott JF , . The National Center on Indigenous Hawaiian Behavioral Health study of prevalence of psychiatric disorders in native Hawaiian adolescents. J Am Acad Child Adolesc Psychiatry. 2006;45:26–36.

Rihmer Z , Akiskal H. Do antidepressants t(h)reat(en) depressives? Toward a clinically judicious formulation of the antidepressant-suicidality FDA advisory in light of declining national suicide statistics from many countries. J Affect Disord. 2006;94:(1-3)3–13.

Sharp SC , Hellings JA. Efficacy and safety of selective serotonin reuptake inhibitors in the treatment of depression in children and adolescents: practitioner review. Clin Drug Investig. 2006;26:247–255.

Vasa R A , Carlino AR , Pine DS. Pharmacotherapy of depressed children and adolescents: current issues and potential directions. Biol Psychiatry. 2006;59:1021–1028.

Cheung AH , Emslie GJ , Mayes TL. Review of the efficacy and safety of antidepressants in youth depression. J Child Psychol Psychiatry. 2005;46:735–754.

Bridge JA , Barbe RP , Birmaher B , . Emergent suicidality in a clinical psychotherapy trial for adolescent depression. Am J Psychiatry. 2005;162:2173–2175.

Lothen-Kline C , Howard DE , Hamburger EK , . Truth and consequences: ethics, confidentiality, and disclosure in adolescent longitudinal prevention research. J Adolesc Health. 2003;33:385–394.

Claassen CA , Larkin GL. Occult suicidality in an emergency department population. Br J Psychiatry. 2005;186:352–353.

Pfeffer C , Lipkins CR , Plutchik R , . Normal children at risk for suicidal behaviour: a two-year follow up. J Am Acad Child Adolesc Psychiatry. 1988;27:34–41.

Joffe RT , Offord DR , Boyle MH. Ontario Child Health Study: suicidal behavior in youth aged 12-16 years. Am J Psychiatry. 1988;145(11):1420–1423.

Whitlock J , Eckenrode J , Silverman D. Self-injurious behaviors in a college population. Pediatrics. 2006;117:1939–1948.

Pfeffer CR , Klerman GL , Hurt SW , . Suicidal children grow up: rates and psychosocial risk factors for suicide attempts during follow-up. J Am Acad Child Adolesc Psychiatry. 1993;32:106–113.

Hawton K , Fagg J. Trends in deliberate self-poisoning and self-injury in Oxford, 1976-1990. BMJ. 1992;304:1409–1411.

Hurry J , Storey P. Deliberate self-harm in young people: the hospital response. Final report to the Department of Health. London (GB): HMSO; 1998.

Kerfoot M. Youth suicide. In: Aggleton P , Hurry H , Warwick I. Young people and mental health. London (GB): Wiley; 2000.

Hoberman H , Garfinkel B. Completed suicide in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1988;27:689–695.

Hurry J. Deliberate self-harm in children and adolescents. Int Rev Psychiatry. 2000;12:31–36.

Diekstra R , Keinhorst C , De Wilde E. Suicide and suicidal behaviour among adolescents. In: Rutter M , Smith D. Psychosocial disorders in young people: time trends and their causes. Chichester (GB): Wiley; 1995.

Kerfoot M , McHugh B. The outcome of childhood suicidal behaviour. Acta Paedopsychiatr. 1992;55:141–145.

Andrews JA , Lewinsohn PM. Suicidal attempts among older adolescents: prevalence and co-occurrence with psychiatric disorders. J Am Acad Child Adolesc Psychiatry. 1992;31:655–662.

Diekstra R. Suicidal behavior and depressive disorders in adolescents and young adults. Neuropsychobiology. 1989;22:194–207.

Burns J , Dudley M , Hazel P , . Clinical management of deliberate self-harm in young people: the need for evidence-based approaches to reduce repetition. Aust N Z J Psychiatry. 2005;39:121–128.

Beck AT. Beyond belief: a theory of modes, personality, and psychopathology. In: Salkovskis PM. Frontiers of cognitive therapy. New York (NY): Guilford; 1996. p 1–25.

Beck AT , Schuyler D , Herman I. Development of suicidal intent scales. In: Beck AT , Rsnik HLP , Lettieri DJ. The prediction of suicide. Bowie (MD): Charles Press; 1974. p 45–56.

World Health Organization (WHO). Suicide rates and absolute numbers of suicide by country (2002). Geneva (CH): WHO; 2003. [cited 2004 Mar 14]. Available from: http://www.who.int/mental_health/prevention/suicide/country_reports/en/index.html (accessed April 2007).

Andrus JK , Fleming DW , Heumann MA , . Surveillance of attempted suicide among adolescents in Oregon, 1988. Am J Public Health. 1991;81:1067–1069.

Velez CN , Cohen P. Suicidal behavior and ideation in a community sample of children: maternal and youth reports. J Am Acad Child Adolesc Psychiatry. 1988;27:349–356.

Brent DA , Perper JA , Moritz G , . Psychiatric risk factors for adolescent suicide: a case-control study. J Am Acad Child Adolesc Psychiatry. 1993;32:521–529.

Shaffer D , Gould MS , Fisher P , . Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry. 1996;53:339–348.

Kessler RC , Borges G , Walters EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Study. Arch Gen Psychiatry. 1999;56:617–626.

Lewinsohn PM , Rohde P , Seeley JR , . Gender differences in suicide attempts from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry. 2001;40:427–434.

International Association for Suicide Prevention (IASP) Executive Committee. IASP guidelines for suicide prevention. Crisis. 1999;20:155–163.

Beautrais AL. Suicide and serious suicide attempts in youth: a multiple-group comparison study. Am J Psychiatry. 2003;160:1093–1099.

Beautrais AL. Methods of youth suicide in New Zealand: trends and implications for prevention. Aust N Z Y Psychiatry. 2000;34:413–419.

Phillips MR , Li X , Zhang Y. Suicide rates in China, 1995-1999. Lancet. 2002;359:835–840.

Health Canada. The Report of the Advisory Group on Suicide Prevention. Acting on what we know: preventing youth suicide in First Nations. Ottawa (ON): Health Canada. Available at: http://www.hc-sc.gc.ca/fnihb-dgspni/fnihb/cp/publications/preventing_youth_suicide.htm (accessed April 2007).

Borowsky IW , Resnick MD , Ireland M , . Suicide attempts among American Indian and Alaska Native youth: risk and protective factors. Arch Pediatr Adolesc Med. 1999;153:573–580.

Shiang J , Blinn R , Bongar B , . Suicide in San Francisco, CA: a comparison of Caucasian and Asian groups, 1987-1994. Suicide Life Threat Behav. 1997;27:80–91.

Wallace JD , Calhoun AD , Powell KE , ; National Centre for Injury Prevention and Control. Homicide and Suicide Among Native Americans, 1979-992. Violence Surveillance Series, No. 2. Atlanta (GA): Centers for Disease Control and Prevention; 1996.

Middlebrook DL , Le Master PL , Beals J , . Suicide prevention in American Indian and Alaska Native communities: a critical review of programs. Suicide Life Threat Behav. 2001;31:(Suppl)132–149.

Gibbs JT. African-American suicide: a cultural paradox. Suicide Life Threat Behav. 1997;27:68–79.

Shaffer D , Gould M , Hicks RC. Worsening suicide rate in black teenagers. Am J Psychiatry. 1994;151(12):1810–1812.

Beautrais AL. Child and young adolescent suicide in New Zealand. Aust N Z J Psychiatry. 2001;35(5):647–653.

Brent DA , Baugher M , Bridge J , . Age- and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatry. 1999;38:1497–1505.

Groholt B , Ekeberg O , Wichstrom L , . Suicide among children and younger and older adolescents in Norway: a comparative study. J Am Acad Child Adolesc Psychiatry. 1998;37:473–481.

Marttunen MJ , Aro HM , Henriksson MM , . Mental disorders in adolescent suicide. Arch Gen Psychiatry. 1991;48:834–839.

Shaffer D , Craft L. Methods of adolescent suicide prevention. J. Clin Psychiatry. 1999;60:(Suppl 2)70–74; discussion 75-76, 113-116.

Brent DA , Perper J , Moritz G , . Suicide in adolescent with no apparent psychopathology. J Am Acad Child Adolesc Psychiatry. 1993;32:494–500.

Evans E , Hawton K , Rodham K. Factors associated with suicidal phenomena in adolescents: a systematic review of population-based studies. Clin Psychol Rev. 2004;24:957–979.

Carta MG , Altamura AC , Hardoy MC . Is recurrent brief depression an expression of mood spectrum disorders in young people? Results of a large community sample. Eur Arch Psychiatry Clin Neurosci. 2003;253:149–153.

Simon NM , Otto MW , Wisniewski Stephen R , . Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry. 2004;161):2222–2229.

Brent DA , Perper JA , Goldstein CE , . Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients. Arch Gen Psychiatry. 1988;45(6):581–588.

Rich CL , Young JG , Fowler RC , . Guns and suicide: possible effects of some specific legislation. Am J Psychiatry. 1990;147:342–346.

Runeson B. Mental disorder in youth suicide: DSM-III-R Axes I and II. Acta Psychiatr Scand. 1989;79:490–497.

Power PJR , Bell RJ , Mills R , . Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis. Aust N Z J Psychiatry. 2003;37:414–420.

Coyle JT , Pine DS , Charney DS , . Depression and bipolar support alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2003;42:1494–1503.

Rey JM , Martin A , Krabman P. Is the party over? Cannabis and juvenile psychiatric disorder: the past 10 years. J Am Acad Child Adolesc Psychiatry. 2004;43:1194–1205.

Pirkola S P , Suominen K , Isometsa ET. Suicide in alcohol-dependent individuals: epidemiology and management. CNS Drugs. 2004;18:423–436.

Power PJ R , Bell RJ , Mills R , . Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis. Aust N Z J Psychiatry. 2003;37:414–420.

Kotila L , Lonnqvist J. Suicide and violent death among adolescent suicide attempters. Acta Psychiatr Scand. 1989;79:453–459.

Gould MS , King R , Greenwald S , . Psychopathology associated with suicidal ideation and attempts among children and adolescents. J Am Acad Child Adolesc Psychiatry. 1998;37:915–923.

Kandel DB. Substance use, depressive mood, and suicidal ideation in adolescence and young adulthood. In: Stiffman AR , Feldman RA. Advancement in adolescent mental health. Greenwich (CT): JAI Press; 1988. p 127–142.

Giaconia RM , Reinherz HZ , Silverman AB , . Traumas and posttraumatic stress disorder in a community population of older adolescents. J Am Acad Child Adolesc Psychiatry. 1995;34:1369–1380.

Mazza JJ. The relationship between posttraumatic stress symptomatology and suicidal behaviour in school-based adolescents. Suicide Life Threat Behav. 2000;30:91–103.

Wunderlich U , Bronisch T , Wittchen HU. Comorbidity patterns in adolescents and young adults with suicide attempts. Eur Arch Psychiatry Clin Neurosci. 1998;248:87–95.

Gould MS. Fisher P , Parides M , . Psychosocial risk factors of child and adolescent completed suicide. Arch Gen Psychiatry. 1996;53:1155–1162.

Pilowsky DJ , Wu L , Anthony JC. Panic attacks and suicide attempts in mid-adolescence. Am J Psychiatry. 1999;156:1545–1549.

Borowsky I , Resnick MD , Ireland M , . Suicide attempts among American Indian and Alaska native youth. Arch Pediatr Adolesc Med. 1999;153:573–80.

Asarnow JR , Carlson G , Guthrie D. Coping strategies, self perceptions, hopelessness and perceived family environments in depressed and suicidal children. J Consult Clin Psychol. 1987;55:361–366.

Kienhorst CWM , de Wilde EJ , Diekstra RFW , . Differences between adolescent suicide attempters and depressed adolescents. Acta Psychiatr Scand. 1992;85:222–228.

Mac Leavey BC , Daly RJ , Murray CM , . Interpersonal problem-solving deficits in self-poisoning patients. Suicide Life Threat Behav. 1987;17:33–49.

Neuringer C. Psychological assessment of suicidal risk. Springfield (IL): Charles C. Thomas; 1974.

Patsiokas AT , Clum GA , Luscomb RL. Cognitive characteristics of suicide attempters. J Consult Clin Psychol. 1979;47:478–484.

Rotheram-Borus MJ , Trautman PD. Dopkins SC , . Cognitive style and pleasant activities among female adolescent suicide attempters. J Consult Clin Psychol. 1990;58:554–561.

Spirito A , Williams CA , Stark LJ , . The Hopelessness Scale for Children: psychometric properties with normal and emotionally disturbed adolescents. J Abnorm Child Psychol. 1988;16:445–458.

Topol P , Reznikoff M. Perceived peer and family relationships, hopelessness and locus of control as factors in adolescent suicide attempts. Suicide Life Threat Behav. 1982;12:141–150.

Beautrais AL , Joyce PR , Mulder RT. Personality traits and cognitive styles as risk factors for serious suicide attempts among young people. Suicide Life Threat Behav. 1999;29:37–47.

Cole Hopelessness DA., social desirability, depression, and parasuicide in two college student samples. J Consult Clin Psychol. 1988;56:131–136.

Howard-Pitney B , La Fromboise TD. Basil M , . Psychological and social indicators of suicide ideation and suicide attempts in Zuni adolescents. J Consult Clin Psychol. 1992;60:473–476.

Lewinsohn PM , Rohde P , Seeley JR. Psychosocial risk factors for future adolescent suicide attempts. J Consult Clin Psychology. 1994;62:297–305.

Reifman A , Windle M. Adolescent suicidal behaviors as a function of depression, hopelessness, alcohol use, and social support: a longitudinal investigation. Am J Community Psychol. 1995;23:329–354.

Rotheram-Borus MJ , Trautman Hopelessness PD., depression, and suicidal intent among adolescent suicide attempters. J Am Acad Child Adolesc Psychiatry. 1988;27:700–704.

Apter A , Plutchik R , van Praag Anxiety HM., impulsivity and depressed mood in relation to suicidal and violent behavior. Acta Psychiatr Scand. 1993;87:1–5.

Brent DA , Johnson B , Bartle S , . Personality disorder, tendency to impulsive violence, and suicidal behavior in adolescents. J Am Acad Child Adolesc Psychiatry. 1993;32:69–75.

Brent DA , Johnson BA , Perper J , . Personality disorder, personality traits, impulsive violence, and completed suicide in adolescents. J Am Acad Child Adolesc Psychiatry. 1994;33:1080–1086.

McKeown RE , Garrison CZ. Cuffe SP , . Incidence and predictors of suicidal behaviours in a longitudinal sample of young adolescents. J Am Acad Child Adolesc Psychiatry. 1998;37:612–619.

Pfeffer CR , Newcorn J , Kaplan G , . Suicidal behavior in adolescent suicidal inpatients. J Am Acad Child Adolesc Psychiatry. 1988;27:357–361.

Sourander A , Helstela L , Haavisto A , . Suicidal thoughts and attempts among adolescents: a longitudinal 8-year follow-up study. J Affect Disord. 2001;63:(1-3)59–66.

Lessard JC , Moretti MM. Suicidal ideation in an adolescent clinical sample: attachment patterns and clinical implications. J Adolesc. 1998;21:383–395.

Brown J , Cohen P , Johnson JG , . Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality. J Am Acad Child Adolesc Psychiatry. 1999;38:1490–1496.

Catallozzi M , Pletcher JR , Schwarz DF. Prevention of suicide in adolescents. Curr Opin Pediatr. 2001;13:417–422.

Fergusson DM , Horwood LJ , Lynskey MT. Childhood sexual abuse and psychiatric disorder in young adulthood. II: psychiatric outcomes of childhood sexual abuse. J Am Acad Child Adolesc Psychiatry. 1996;35:1365–1374.

Johnson JG , Cohen P , Gould MS , . Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Arch Gen Psychiatry. 2002;59:741–749.

Molnar BE , Shade SB , Kral AH , . Suicidal behavior and sexual/physical abuse among street youth. Child Abuse Negl. 1998;22:213–222.

Silverman AB , Reinherz HZ , Giaconia RM. The long-term sequelae of child and adolescent abuse: a longitudinal community study. Child Abuse Negl. 1996;20:709–723.

Statham DJ , Heath AC , Madden PA , . Suicidal behaviour: an epidemiological and genetic study. Psychol Med. 1998;28:839–855.

Deykin EY , Alpert JJ , McNamara JJ. A pilot study of the effect of exposure to child abuse or neglect on adolescent suicidal behaviour. Am J Psychiatry. 1985;142:1299–1303.

Kaplan SJ , Pelcovitz D , Salzinger S , . Adolescent physical abuse and suicide attempts. J Am Acad Child Adolesc Psychiatry. 1997;36:799–808.

Shaffer D , Wilcox H , Lucas C , . The development of a screening instrument for teens at risk for suicide. Poster presented at the 1996 meeting of the American Academy of Child and Adolescent Psychiatry (AACAP); 1996; New York. In: AACAP. Practice parameter for the assessment and treatment of children and adolescents with suicidal behaviour. J Am Acad Child Adolesc Psychiatry. 2001;40:(7 Suppl)24S–51S.

Choquet M , Darves-Bornoz JM , Ledoux R , . Self-reported health and behavioral problems among adolescent victims of rape in France: results of a cross-sectional survey. Child Abuse Negl. 1997;21:823–832.

Gutierrez P , King CA , Ghaziuddin N. Adolescent attitudes about death in relation to suicidality. Suicide Life Threat Behav. 1996;26:8–18.

Overholser J , Hemstreet A , Spirito A , . Suicide awareness programs in the schools: effects of gender and personal experience. J Am Acad Child Adolesc Psychiatry. 1989;28:925–930.

Agerbo E , Nordentoft M , Mortensen Familial PB., psychiatric, and socioeconomic risk factors for suicide in young people: nested case control study. BMJ. 2002;325:74.

McGuffin P , Marusic A , Farmer A. What can psychiatric genetics offer suicidology? Crisis. 2001;22:61–65.

Brent DA , Perper JA , Moritz G , . Familial risk factors for adolescent suicide: a case-control study. Acta Psychiatr Scand. 1994;89:52–58.

Fergusson DM , Lynskey M. Childhood circumstances, adolescent adjustment, and suicide attempts in a New Zealand birth cohort. J Am Acad Child Adolesc Psychiatry. 1995;34:612–622.

Kashani JH , Goddard P , Reid JC. Correlates of suicidal ideation in a community sample of children and adolescents. J Am Acad Child Adolesc Psychiatry. 1989;28:912–917.

Kerfoot M , Dyer E , Harrington V , . Correlates and short-term course of self-poisoning in adolescents. Br J Psychiatry. 1996;168:38–42.

Beautrais AL , Joyce PR , Mulder RT. Risk factors for serious suicide attempts among youths aged 13 through 24 years. J Am Acad Child Adolesc Psychiatry. 1996;35:1174–1182.

Fergusson DM , Woodward LJ , Horwood LJ. Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychol Med. 2000;30:23–39.

Lewinsohn PM , Rohde P , Seeley J. Psychosocial characteristics of adolescents with a history of suicide attempt. J Am Acad Child Adolesc Psychiatry. 1993;32:60–68.

Tousignant M , Bastien MF , Hamel S. Suicidal attempts and ideations among adolescents and young adults: the contribution of the father's and mother's care and of parental separation. Soc Psychiatry Psychiatr Epidemiol. 1993;28:256–261.

Hollis Depression C., family environment, and adolescent suicidal behaviour. J Am Acad Child Adolesc Psychiatry. 1996;35:622–630.

Sauvola A , Rasanen PK , Joukamaa MI , . Mortality of young adults in relation to single-parent family background: a prospective study of the northern Finland 1966 birth cohort. Eur J Public Health. 2001;11:284–286.

de Wilde EJ , Kienhorst IC , Diekstra RF , . The relationship between adolescent suicidal behaviour and life events in childhood and adolescence. Am J Psychiatry. 1992;149:45–51.

Hawton K. Suicide and attempted suicide among children and adolescents. Newbury Park (CA): Sage; 1986.

Brent DA , Perper JA , Moritz G , . Stressful life events, psychopathology and adolescent suicide: a case control study. Suicide Life Threat Behav. 1993;23:179–187.

Rich CL , Fowler RC , Fogarty LA , . San Diego Suicide Study, III: relationships between diagnoses and stressors. Arch Gen Psychiatry. 1988;45:589–592.

Runeson B. Psychoactive substance use disorder in youth suicide. Alcohol Alcohol. 1990;25:561–568.

Beautrais AL , Joyce PR , Mulder RT. Precipitating factors and life events in serious suicide attempts among youths aged 13 though 24 years. J Am Acad Child Adolesc Psychiatry. 1997;36:1543–1551.

Lewinsohn PM , Rohde P , Seeley JR. Adolescent suicidal ideation and attempts: Prevalence, risk factors and clinical implications. Clin Psychol Sci Pract. 1996;3:25–26.

Brent D , Perper J , Moritz C , . Suicide in affectively ill adolescents: a case control study. J Affect Disord. 1994;31:193–202.

Daley AJ , Copeland RJ , Wright NP , . Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: a randomized, controlled trial. Pediatrics. 2006;118:2126–2134.

Haarasilta L , Marttunen M , Kaprio J , . Major depressive episode and physical health in adolescents and young adults: results from a population-based interview survey. Eur J Public Health. 2005;15:489–93.

Rafiroiu C , Sargent RG , Parra-Medina D , . Covariations of adolescent weight-control, health-risk and health-promoting behaviors. Am J Health Behav. 2003;27:3–14.

Penn JV , Esposito CL , Schaeffer LE , . Suicide attempts and self-mutilative behavior in a juvenile correctional facility. J Am Acad Child Adolesc Psychiatry. 2003;42:762–769.

Hawton K , Hall S , Simkin S , . Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990-2000. J Child Psychol. 2003;44:1191–1198.

Hallfors D , Cho H , Brodish PH , . Identifying high school students “at risk” for substance use and other behavioral problems: implications for prevention. Subst Use Misuse. 2006;41:1–15.

Gillman JL , Kim HS , Alder SC , . Assessing the risk factors for suicidal thoughts at a nontraditional commuter school. J Am Coll Health. 2006;55:17–26.

Kaltiala-Heino R , Rimpela M , Marttunen M , . Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ. 1999;319:348–351.

Forero R. McLellanl , Rissel C , . Bullying behaviour and psychosocial health among school students in New South Wales, Australia: cross-sectional survey. BMJ. 1999;319:344–348.

Kaltiala-Heino R , Rimpela M , Maritrunen M , . Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ. 1999;319:348–351.

Conrad N. Stress and knowledge of suicidal others as factors in suicidal behavior of high school adolescents. Issues Ment Health Nurs. 1992;13:95–104.

Harkavy FJ , Asnis G , Boeck M , Di Fiore J. Prevalence of specific suicidal behaviours in a high school sample. Am J Psychiatry. 1987;144:1203–1206.

Orbach I , Kedem P , Gorchover O , . Fears of death in suicidal and nonsuicidal adolescents. J Abnorm Psychol. 1993;102:553–558.

De Wilde E , Kienhorst I , Diekstra RFW , . The specificity of psychological characteristics of adolescent suicide attempters. J Am Acad Child Adolesc Psychiatry. 1993;32:51–59.

Stein D , Witzum E , Brom D , . The association between adolescents’ attitudes toward suicide and their psychosocial background and suicidal tendencies. Adolescence. 1992;27:949–959.

Brent DA , Perper JA , Moritz G , . Psychiatric sequelae to the loss of an adolescent peer to suicide. J Am Acad Child Adolesc Psychiatry. 1993;32:509–517.

Brent DA , Moritz C. Bridge J , . Canobbio R. Long-term impact of exposure to suicide: a three-year controlled follow-up. J Am Acad Child Adolesc Psychiatry. 1996;35:646–653.

Pfeffer CR , Martins P , Mann J , . Child survivors of suicide: psychosocial characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36:65–74.

Hazell P , Lewin T. Friends of adolescent suicide attempters and completers. J Am Acad Child Adolesc Psychiatry. 1993;32:76–81.

Bollen KA , Philips DP. Imitative suicides: a national study of the effects of television news stories. Am Sociol Rev. 1982;47:802–809.

Gould MS. Shaffer D. The impact of television movies: evidence of imitation. N Engl J Med. 1986;315:690–694.

Hafner H , Schmidtke A. Do televised fictional suicide models produce suicides? In: Pfeffer CR. Suicide among youth: perspectives on risk and prevention. Washington (DC): American Psychiatric Press; 1989.

Gould MS. Suicide and the media. Ann N Acad Y Sci. 2001;932:200–221.; discussion 221-224. In: Hendin H , Mann JJ , editors. The clinical science of suicide prevention New York (NY): Ann N Acad Y Sci; 2001.

Velting DM , Gould MS. Suicide contagion. In: Maris RW , Silverman MM. Review of suicidology. New York (NY): Guilford; 1997. p 96–137.

Gould MS , Wallenstein S , Kleinman M. Time-space clustering of teenage suicide. Am J Epidemiol. 1990;131:71–78.

Gould MS. Wallenstein S , Kleinman M , . Suicide clusters: an examination of age specific effects. Am J Public Health. 1990;80:211–212.

Faulkner AH , Cranston K. Correlates of same-sex sexual behaviour in a random sample of Massachusetts high school students. Am J Public Health. 1998;88:262–266.

Fergusson DM , Horwood LJ , Beautrais AL. Is sexual orientation related to mental health problems and suicidality in young people? Arch Gen Psychiatry. 1999;56:876–880.

Garofalo R , Wolf RC , Kessel S , . The association between health risk behaviours and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998;101:895–902.

Lock J , Steiner Gay H., lesbian, and bisexual youth risks for emotional, physical, and social problems: results from a community-based survey. J Am Acad Child Adolesc Psychiatry. 1999;38:297–304.

Remafedi G , French S , Story M , . The relationship between suicide risk and sexual orientation: results of a population-based study. Am J Public Health. 1998;88:57–60.

Blake SM , Ledsky R , Lehman T , . Preventing sexual risk behaviours among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools. Am J Public Health. 2001;91:940–946.

Russell ST , Joyner K. Adolescent sexual orientation and suicide risk: evidence from a national study. Am J Public Health. 2001;91:1276–1281.

McDaniel JS , Purcell D , D'Augelli AR. The relationship between sexual orientation and risk for suicide: research findings and future directions for research and prevention. Suicide Life Threat Behav. 2001;31:(Suppl)84–105.

Brent DA , Baugher M , Birmaher B , . Compliance with recommendations to remove firearms in families participating in a clinical trial for adolescent depression. J Am Acad Child Adolesc Psychiatry. 2000;39:1220–1226.

Shah S , Hoffman RE , Wake L , . Adolescent suicide and household access to firearms in Colorado: results of a case-control study. J Adolesc Health. 2000;26:157–63.

Kellermann AL , Rivara FP , Somes G , . Suicide in the home in relation to gun ownership. N Engl J Med. 1992;327:467–472.

Grossman DC , Mueller BA , Riedy C , . Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. 2005;293:707–714.

Cummings P , Grossman DC , Rivara FP , . State gun safe storage laws and child mortality due to firearms. JAMA. 1997;278:1084–1086.

Loftin C , McDowall D , Wiersema B , . Effects of restrictive licensing of handguns on homicide and suicide in the District of Columbia. N Engl J Med. 1991;325:1615–1620.

Boyd JH , Moscicki EK. Firearms and youth suicide. Am J Public Health. 1986;76:1240–1242.

Brent DA , Perper JA , Al Iman CJ. Alcohol, firearms, and suicide among youth: temporal trends in Allegheny County, Pennsylvania, 1960 to 1983. JAMA. 1987;257:3369–3372.

Lester D. Preventive effect of strict handgun control laws on suicide rates. Am J Psychiatry. 1983;140:1259.

Sloan JH , Rivara FP , Reay DT , . Firearm regulations and rates of suicide: a comparison of two metropolitan areas. N Engl J Med. 1990;322:369–373.

Carrington PJ , Moyer S. Gun control and suicide in Ontario. Am J Psychiatry. 1994;151:606–608.

Bennett PJ , McMahon WM , Watabe J , . Tryptophan hydroxylase polymorphisms in suicide victims. Psychiatr Genet. 2000;10:13–17.

Mann JJ , Stoff DM. A synthesis of current findings regarding neurobiological correlates and treatment of suicidal behavior. Ann N Acad Y Sci. 1997;836:352–363.

Nielsen DA , Goldman D. Virkkunen M , . Suicidality and 5-hydroxyindoleacetic acid concentration associated with a tryptophan hydroxylase polymorphism. Arch Gen Psychiatry. 1994:51:34–38.

Nielsen DA , Virkkunen M , Lappalainen J , . A tryptophan hydroxylase gene marker for suicidality and alcoholism. Arch Gen Psychiatry. 1998;55:593–602.

Arango V , Underwood MD , Boldrini M , . Serotonin 1A receptors, serotonin transporter binding and serotonin transporter mRNA expression in the brainstem of depressed suicide victims. Neuropsychopharmacology. 2001;25:892–903.

Kruesi MJ , Swedo SE , Hamburger SD , . Concentration gradient of CSF monoamine metabolites in children and adolescents. Biol Psychiatry. 1988;24:507–514.

Rubenstein JL , Heeren T , Housman D , . Suicidal behavior in “normal” adolescents: risk and protective factors. Am J Orthopsychiatry. 1989;59:59–71.

Rubenstein JL , Halton A , Kasten L , . Suicidal behavior in adolescents: stress and protection in different family contexts. Am J Orthopsychiatry. 1998;68:274–284.

Zhang J , Jin S. Determinants of suicide ideation: a comparison of Chinese and American college students. Adolescence. 1996;31:451–467.

Pfeffer CR , Klerman GL , Hurt SW , . Suicidal children grow up: demographic and clinical risk factors for adolescent suicide attempts. J Am Acad Child Adolesc Psychiatry. 1991;30:609–616.

Kovacs M , Goldston D , Gatsonis C. Suicidal behaviors and childhood-onset depressive disorders: a longitudinal investigation. J Am Acad Child Adolesc Psychiatry. 1993;32:8–20.

Goldston DB , Daniel S , Reboussin DM , . First-time suicide attempters, repeat attempters, and previous attempters on an adolescent inpatient psychiatry unit. J Am Acad Child Adolesc Psychiatry. 1996;35:631–639.

Stein D , Apter A , Ratzoni G , . Association between multiple suicide attempts and negative affects in adolescents. J Am Acad Child Adolesc Psychiatry. 1998;37:488–494.

Kotila L , Lonnqvist J. Adolescent suicide attempts: sex differences predicting suicide. Acta Psychiatr Scand. 1988;77:264–270.

Cohen-Sandler R , Berman A , King A. A follow-up study of hospitalized suicidal children. J Am Acad Child Psychiatry. 1982;21:398–403.

Barter J , Swaback D , Todd D. Adolescent suicide attempts: A follow-up study of hospitalized patients. Arch Gen Psychiatry. 1968;19:523–527.

Mehr M , Zeltzer L , Robinson R. Continued self-destructive behaviors in adolescent suicide attempters: part I. J Adolesc Health Care. 1981;1:269–74.

Otto U. Suicidal acts by children and adolescents: a follow-up study. Acta Psychiatr Scand Suppl. 1972;233:7–123.

Spirito A , Plummer B , Gispert M , . Adolescent suicide attempts: outcomes at follow-up. Am J Orthopsychiatry. 1992;62:464–468.

Pfeffer CR , Peskin JR. Siefker CA. Suicidal children grow up: psychiatric treatment during follow-up period. J Am Acad Child Adolesc Psychiatry. 1992;31:679–685.

Shaffer D , Garland A , Gould M , . Preventing teenage suicide: a critical review. J Am Acad Child Adolesc Psychiatry. 1988;27:675–687.

Shafii M , Carrigan S , Whittinghill JR , . Psychological autopsy of completed suicide in children and adolescents. Am J Psychiatry. 1985;142:1061–1064.