title: Risk factors and characteristics of suicide attempts among 381 suicidal adolescents.
abstract: OBJECTIVE
  This study explored the relationships between suicidal adolescents and their parents, siblings and friends. It examined how much adolescents talked to their parents before suicide attempts, the frequency of self-mutilation, the extent of suicidal ideation, previous suicide attempts and suicide attempts in the adolescent's surroundings.
  
  
  METHODS
  We performed a cross-sectional case-control study that focused on 381 adolescents aged 10-17 years who were admitted to hospitals across Denmark after suicide attempts with acetaminophen and 296 age- and gender-matched controls recruited from schools. The study used questionnaires and medical and child psychiatric records.
  
  
  RESULTS
  The study group were ten times more likely to report dissociated parental relationships than the control group (41.5% versus 4%), and there were significant relationships between these reports and feelings of not being heard (p < 0.0001), dissociated relationships with friends (p < 0.0001) and siblings (p < 0.0001) and self-mutilation (p = 0.009). Almost two-thirds (62.5%) of the suicidal adolescents who tried to talk to their parents about their problems felt unheard, and there was a significant relationship between this feeling and the duration of suicidal ideation (p = 0.01) and self-mutilation (p = 0.003).
  
  
  CONCLUSIONS
  Early risk factors for suicide were dissociated relationships with parents, siblings and friends, feeling unheard, self-mutilation and extended suicidal ideation.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Nordsjaellands Hospital, Hillerød, Denmark. rikke.hedeland@regionh.dk.
authors.forename: Rikke Lindgaard
authors.initials: RL
authors.lastname: Hedeland
authors.affiliation: Department of Pediatric and Adolescent Medicine, Nordsjaellands Hospital, Hillerød, Denmark.
authors.forename: Grete
authors.initials: G
authors.lastname: Teilmann
authors.affiliation: Department of Pediatric and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Marianne Hørby
authors.initials: MH
authors.lastname: Jørgensen
authors.affiliation: Department of Pediatric and Adolescent Medicine, Nordsjaellands Hospital, Hillerød, Denmark.
authors.forename: Line Rejkjaer
authors.initials: LR
authors.lastname: Thiesen
authors.affiliation: Department of Pediatric and Adolescent Medicine, Nordsjaellands Hospital, Hillerød, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Andersen
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010287:Parent-Child Relations; D012652:Self Mutilation / Q000453:epidemiology; D012801:Sibling Relations; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D000082:Acetaminophen
keywords: Acetaminophen; Adolescents; Suicidal behaviour; Suicide attempts