title: The immediate management of suicide attempts in children and adolescents: psychologic aspects.
abstract: Adolescent suicide is steadily on the increase. Many attempters have previously consulted a physician, but have concealed their suicidal intent. When the attempt is made the family doctor is often the first physician contacted. In children under 12 years of age, the population at risk for suicide includes those who feel abandoned because of neglect, child abuse, or bereavement. The early adolescent may suicide by mis-adventure. Adolescents at risk include those who experience rage associated with feelings of utter helplessness and hopelessness and those who use self-destructive behavior to manipulate other people in the expectation that these other people will gratify their wishes. To ensure adequate medical and psychologic care, the physician should hospitalize the suicide attempter. Future suicide attempts are less likely if the physician can elicit the adolescent's awareness of his anger, diminish the child's self-contempt, help him to explore nondestructive solutions to his problems, and increase his awareness that his death by suicide would cause irreparable emotional damage to his family. The initial management provides the data required for formulation of an aftercare plan that the physician may coordinate and monitor.
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry; D000328:Adult; D000786:Anger; D002648:Child; D002665:Child Psychiatry; D005194:Family Practice; D005260:Female; D006760:Hospitalization; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D009042:Motivation; D012561:Schizophrenia, Childhood / Q000150:complications; D013405:Suicide / Q000453:epidemiology; D013406:Suicide, Attempted / Q000453:epidemiology; D000092864:Suicide Prevention