Depression and exposure to suicide predict suicide attempt.
OBJECTIVE
To examine the role of depression and exposure to peer or family suicide and their interaction as risk factors for adolescent suicide attempts.


METHODS
The study used the public-use data set of the National Longitudinal Study of Adolescent Health (Add Health), which is a nationally representative stratified sample of U.S. high school students. Sample size was 4,719. Analyses predicted suicide attempts from preexisting depression and exposure to suicide of a friend or family member, controlling for previous suicide attempts, exposure, and depression.


RESULTS
The greatest risk for future suicide attempts (relative risk = 3.3), was attributable to an attempt in the preceding year, controlling for preexisting and current depression and exposure. There was a main effect of exposure with the next highest relative risk of 3.2. A similar risk ratio, 3.2, was found for the difference between no depression and current severe depression, controlling for past depression and attempts. There was no evidence of an interaction between exposure to a peer or family member suicide attempt and depression. Supplementary analyses found that exposure to a friend or family member suicide attempt or completed suicide each added significantly to risk for adolescents regardless of depression levels.


CONCLUSIONS
Exposure to suicidal behavior in a friend or family member poses risk equivalent to the risk posed by becoming severely depressed. Attending to such risks could benefit clinical practice with adolescence and public health suicide prevention efforts.
Department of Psychiatry, The Institute for Juvenile Research, University of Illinois at Chicago, Chicago, Illinois.
Sonali
S
Nanayakkara
Diane
D
Misch
Laura
L
Chang
David
D
Henry
D000293:Adolescent; D003863:Depression / Q000523:psychology*; D005190:Family; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D063588:National Longitudinal Study of Adolescent Health; D010379:Peer Group; D012307:Risk Factors; D012720:Severity of Illness Index; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*; D014481:United States
child/adolescent; depression; life events/stress; mood disorders; suicide/self harm