Fifteen year olds at risk of parasuicide or suicide: how can we identify them in general practice?
BACKGROUND
Within most western countries, suicide is the second leading cause of death amongst adolescents.


OBJECTIVE
This paper aims to help GPs identify 15-year-old adolescents at increased risk from parasuicide and suicide.


METHODS
The authors reviewed the case notes of 2359 fifteen year olds from 34 randomly selected general practices. Subjects were divided into two groups: (i) those who had made a suicide attempt at age 15; and (ii) those who had made no suicide attempt at age 15. The main outcome measures were the differences between those who had made a suicide attempt and those who had not with respect to GP consulting rates and reasons for consulting.


RESULTS
The 26 subjects (1%) who had attempted suicide at age 15 consulted their GP four times per year compared with 2.3 times for those who had not attempted suicide. Twice as many adolescents who had attempted suicide consulted for upper respiratory tract infection (URTI), and nearly nine times as many consulted more than once for mental health concerns. The average attendance rate for those who had attempted suicide was greater than for those in the control comparison group who consulted their GP for mental health concerns; the attendance rate of those in the control group who had not consulted for mental health issues was lower still.


CONCLUSIONS
(i) Fifteen year olds more at risk from parasuicide can be found amongst frequent attenders at general practice. (ii) Consulting more than once for mental health concerns or URTI where there are no physical signs could be an indicator of suicide risk.
D000293:Adolescent; D016022:Case-Control Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D018570:Risk Assessment; D012606:Scotland; D016728:Self-Injurious Behavior; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000092864:Suicide Prevention