title: Suicidal behavior in adolescents with comorbid depression and alcohol abuse.
abstract: Depression, alcohol abuse and suicidality each continue to threaten adolescent populations throughout the world. The comorbidity between these diseases has been found to be up to 73% with consistent positive correlations between adolescent drinking, depression and suicidality. Alcohol abuse, depression and suicidal behavior in adolescents have also been found to have biochemical and genetic correlates. This article explores the contributing and causative factors and directional models underlying such prevalent comorbidities. Alcohol use is shown to be both a distal and proximal cause of suicide attempts in adolescent populations. Individuals with both alcoholism and depression who attempt or complete suicide often present with significantly high levels of aggression and impulsivity. These factors may be caused or nuanced by poor or underdeveloped coping skills as well as other comorbid psychiatric conditions. Such behaviors, alone or in comorbidity, may be a consequence of childhood abuse, social pressures, low self-esteem and/or delinquency- all of which may be particularly salient among adolescent populations. Such adolescent stressors are implicated as the cause for the self-medication model. Some studies suggest that depression encourages alcohol use as self-medication and then leads to suicidality, while others imply that the initial alcohol consumption is responsible for increasing depressive and suicidal symptoms in adolescents. This article discusses the social stigma associated with alcoholism, depression and suicidality, and how that may serve to enhance these disorders in adolescent populations. Many directional models are presented based on past research and as suggestions for future research. There is a lot that can be done by clinicians, legal and educational professionals and society at large that may help to prevent and treat such problems.
authors.affiliation: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Ganz
authors.forename: L
authors.initials: L
authors.lastname: Sher
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000374:Aggression / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D002649:Child Abuse / Q000523:psychology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D019317:Evidence-Based Medicine; D006801:Humans; D007604:Juvenile Delinquency / Q000523:psychology; D008016:Life Change Events; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013405:Suicide / Q000523:psychology*