title: Psychosocial stressors more common in adolescent suicides with alcohol abuse compared with depressive adolescent suicides.
abstract: OBJECTIVE
  Relationships between stressors and psychiatric diagnoses were studied among 13- to 19-year-old adolescent suicide victims with alcohol abuse/dependence (N = 14), depressive disorders (N = 18), and the remainder (N = 21).
  
  
  METHODS
  The study included all adolescent suicides (N = 53) during a nationwide psychological autopsy study of suicides in Finland during a 12-month period (N = 1397). The data were collected through interviews with the victims' parents and health care personnel and from official records.
  
  
  RESULTS
  Interpersonal separations and difficulties regarding discipline or the law were common recent stressors among the alcohol abuse victims, and interpersonal conflicts and somatic illness among those with depressive disorders. Compared with the depressive victims, an unstable earlier family history was more common among the alcohol abusers. The accumulation of stressors and weakened parental support during the previous year were also more frequently found in the alcohol abuse victims.
  
  
  CONCLUSIONS
  The results indicate that specific psychosocial stressors may be critical for suicidal adolescents with different diagnoses. In the evaluation of suicidal adolescent substance abusers, particularly recent interpersonal separations and family support need to be carefully weighed. Disruptions in the adolescent's interpersonal relationships, excess accumulation of stress, and lacking support from the family may be warning signs of suicide potential and indications for additional social support, for more intensive treatment, or for a change in the treatment setting.
authors.affiliation: National Public Health Institute, Department of Mental Health, Helsinki, Finland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Marttunen
authors.forename: H M
authors.initials: HM
authors.lastname: Aro
authors.forename: M M
authors.initials: MM
authors.lastname: Henriksson
authors.forename: J K
authors.initials: JK
authors.lastname: Lönnqvist
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation; D016241:Child of Impaired Parents / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D010287:Parent-Child Relations; D010552:Personality Assessment; D010553:Personality Development; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications*; D013405:Suicide / Q000523:psychology*; D000092864:Suicide Prevention