Major depressive disorder in adolescents exposed to a friend's suicide.
OBJECTIVE
To evaluate whether the risk of DSM-III major depressive disorder (MDD) is uniform across the 6 months after adolescent exposure to a friend's suicide, and to examine potential moderating or mediating processes that may influence the risk of new-onset MDD.


METHODS
One-month incidence rates of MDD were compared between 129 adolescents who were exposed to a friend's suicide between December 1988 and March 1991 and 145 similar-aged, unexposed community controls participating in the Youth Exposed to Suicide study. Clinical, family, and social factors that antedated the exposure were examined as predictors of new-onset MDD within 1 month of the suicide.


RESULTS
Exposed adolescents had a markedly increased risk of developing new-onset MDD that was restricted to a narrow period of time, within 1 month after exposure. In contrast, there were no differences in the incidence of MDD between the groups in months 2 to 6. Past history of alcohol abuse increased the risk of exposure to suicide, which subsequently increased the risk of new-onset MDD within 1 month of exposure. Exposed youths who had both a family history of MDD and feelings of accountability for the death were at considerably increased risk of new-onset MDD.


CONCLUSIONS
For adolescents exposed to a friend's suicide, events surrounding the death interact with family history of MDD to greatly increase the risk for new-onset MDD.
Bridge
Jeffrey A
JA
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. bridgeja@msx.upmc.edu
Day
Nancy  L
N
Day
Richard
R
Richardson
Gale A
GA
Birmaher
Boris
B
Brent
David A
DA
D000293:Adolescent; D000328:Adult; D003865:Major Depressive Disorder / Q000209:etiology*; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D013405:Suicide / Q000523:psychology*