Dr. Thomas Kelly and colleagues collected data from 188 females and 315 males, aged 12 to 19 years, who were diagnosed with an alcohol or substance use disorder and who participated in studies between 1991 and 2000 at the Pittsburgh Adolescent Alcohol Research Center. The adolescents completed standardized assessments of substanceand nonsubstance-related psychiatric disorders. Both the adolescents and their parents answered standardized questions about age of onset for all diagnosed psychiatric disorders. Adolescents who attempted suicide and their parents estimated the age(s) at which the adolescent attempted suicide.
Overall, 29 males and 56 females made one or more suicide attempts during their lifetimes. Males with hallucinogen use disorders, inhalant use disorders, sedative-hypnotic use disorders, and attention-deficit hyperactivity disorder were more likely to have attempted suicide than males who were not diagnosed with these disorders. Male suicide attempters had more symptoms of mood, alcohol, and disruptive behavior disorders compared with male nonattempters. There existed an earlier age of onset for alcohol use disorders and conduct disorders among male suicide attempters compared with the age of onset among males with these disorders who did not attempt suicide.
Females with conduct disorders and substance use disorders (other than cannabis use disorders) were at higher risk for attempting suicide than females who were not diagnosed with conduct disorders or noncannabis substance use disorders. Female suicide attempters had more symptoms of substance use disorders (other than cannabis use disorders) and mood disorders compared with female nonattempters. Female suicide attempters with mood disorders had an earlier age of onset of mood disorders compared with the age of onset for mood disorders among female nonattempters.
The researchers also found that risk of attempting suicide generally begins to increase at age 11 for females and about 12.5 for males with substance use disorders. Co-occurring mood disorders place both males and females with substance use disorders at highest risk for attempting suicide.
WHAT IT MEANS: These findings indicate that clinicians should closely monitor adolescents with substance use disorders for suicide risk. Clinicians should also be aware of gender differences in suicidal behavior based on the course and severity of a co-occurring psychiatric disorder in this population.
Dr. Kelly and colleagues published these findings in the January 2004 issue of Drug and Alcohol Dependence.
Journal
Drug and Alcohol Dependence