[Suicidal behavior in adolescents in Switzerland: role of physicians].
BACKGROUND
In most industrialized countries, suicide represents the second leading cause of death among adolescents. Swiss teenagers exhibit one of the highest death rates by suicide in Europe; however, the prevalence of suicidal conducts (suicidal ideas, projects and attempts) in Switzerland is not known.


OBJECTIVE
To assess the prevalence of suicidal conducts among Swiss adolescents and to compare these figures with available data from other countries. To establish how suicidal adolescents use health services in comparison with non-suicidal adolescents.


METHODS
Bivariate analyses have been performed using data from the "SMASH" study (Swiss Multicenter Adolescent Survey on Health), a national survey on the health and lifestyles of 9,268 15 to 20 years in-school youth (3,993 girls et 5,275 boys). Within a self-administered anonymous questionnaire of 80 items, five specific questions focused on suicidal conducts and lead to the distribution of respondents in four groups: no suicidal concern, suicidal ideas, suicidal plans, suicide attempt.


RESULTS
Regarding the last 12 months, 5,144 teenagers (55.5%) report no suicide preoccupation at all; 2,376 (25.6%) report suicide ideas only, 1,366 (14.7%) report suicidal projects and 274 (3%) report suicide attempts. Only 40% of respondents who report a suicide attempt have talked about it to someone in their circle of family or friends. Moreover, less than 20% have spoken of their suicide with a psychologist, and although they see physicians as often as the rest of the sample, only 10% have discussed their attempt with one of them. In comparison with those free of suicidal concerns, suicidal adolescents report significantly more health problems and concerns: they feel more often tired or depressed and use medication more often. They also seem to exhibit more deviant behaviors like alcohol and drug use or runaway.


CONCLUSIONS
Suicidal conducts, especially suicide attempts are much more prevalent among Swiss adolescents, but a small minority is acknowledged and treated by the medical profession. Physicians should be aware of this pathology and better trained both in term of detection and treatment.
Rey
C
C
Institut universitaire de médecine sociale et préventive, Lausanne, Suisse.
Michaud
P A
PA
Narring
F
F
Ferron
C
C
D000293:Adolescent; D002648:Child; D003219:Confidentiality; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D010819:Physician's Role; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D013557:Switzerland / Q000453:epidemiology