title: Factors associated with repeat suicide attempts among adolescents.
abstract: OBJECTIVE
  To determine potential risk factors associated with repeat suicide attempts among adolescents.
  
  
  METHODS
  Retrospective medical record review of all patients aged 13-20 years who presented to the emergency department at an inner city tertiary hospital after attempted suicide between 1994 and 1996. Subjects were identified using the International Classification of Diseases (ICD-9) codes E950.0 to E959.9 for attempted suicide. Study variables included demographic parameters, chronic medical conditions/illnesses, psychiatric and substance abuse disorders, history of sexual abuse and previous and subsequent suicide attempts. Variables univariately associated with repetition at p < 0.25 were entered into a multiple regression analysis.
  
  
  RESULTS
  Eighty seven per cent of patients presented with a drug overdose. Seventy-six per cent of all subjects attempted suicide in the context of a dispute or relationship break-up. At least one psychiatric disorder was present in 76% of subjects at the index attempt. The most frequently diagnosed disorders were depression (45.5%) and drug (34%) and alcohol abuse (27%). Variables predicting repetition within 12 months were drug (OR = 3.891, p = 0.02) and alcohol abuse (OR = 3.56, p = 0.05), non-affective psychotic disorders (OR = 3.81, p = 0.04), and chronic medical conditions/illness (OR = 3.29, p = 0.03). A history of sexual abuse was almost significant (OR = 3.03, p = 0.06).
  
  
  CONCLUSIONS
  Adolescents most likely to re-attempt suicide with 12 months present with either substance abuse, non-affective psychotic disorders, chronic medical conditions, or a history of sexual abuse. All adolescents with a possible suicide attempt should receive a comprehensive mental health and psychosocial assessment. Closer scrutiny of the role of chronic illnesses and sexual abuse in both future research and clinical management is urged. A broad based, multidisciplinary intervention approach is recommended.
authors.affiliation: Adolescent Medical Consultancy Service, QMB, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Vajda
authors.forename: K
authors.initials: K
authors.lastname: Steinbeck
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology