Child and adolescent suicide: Epidemiology, risk factors, and approaches to prevention

Pediatric Drugs

Volumn 5, Issue 4, 2003, Pages 243-265

  Pelkonen, Mirjami ^a,b   Marttunen, Mauri ^a,b  

^a NATIONAL PUBLIC HEALTH INSTITUTE   (Finland)

^b UNIVERSITY OF HELSINKI   (Finland)

Author keywords

[No Author keywords available]

Indexed keywords

FLUOXETINE; FLUPENTIXOL; IMIPRAMINE; PAROXETINE; PLACEBO; SEROTONIN UPTAKE INHIBITOR; TRICYCLIC ANTIDEPRESSANT AGENT; VENLAFAXINE;

ADOLESCENT; AGE DISTRIBUTION; AUTOPSY; BEHAVIOR THERAPY; CARDIOTOXICITY; CAUSE OF DEATH; CHILD; CHILD BEHAVIOR; CHILD PSYCHIATRY; CLINICAL TRIAL; DEPRESSION; DRUG EFFICACY; ELECTROCONVULSIVE THERAPY; EPIDEMIOLOGICAL DATA; FAMILY; HIGH RISK POPULATION; HUMAN; MENTAL DISEASE; META ANALYSIS; PRIMARY PREVENTION; PRIORITY JOURNAL; PSYCHOPHARMACOTHERAPY; REVIEW; RISK FACTOR; SECONDARY PREVENTION; SEX DIFFERENCE; SOCIAL PSYCHOLOGY; SUICIDAL BEHAVIOR;

EID: 0037262745     PISSN: 11745878     EISSN: None     Source Type: Journal    
DOI: 10.2165/00128072-200305040-00004     Document Type: Review

References (179)

1. Statistics Finland. Causes of death 2000. Helsinki: Statistics Finland, 2002
2. WHO Statistical Information System. WHO, 2001 [online]. Available from URL: http:\\www.who.int\whosis [Accessed 2003 Mar 5]
3. McClure GMG. Suicide in children and adolescents in England and Wales 1970-1998. Br J Psychiatry 2001; 178: 469-74
4. Lewinsohn PM, Rohde P, Seeley JR, et al. Gender differences in suicide attempts from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry 2001; 40: 427-34
5. Fleming JE, Offord DR. Epidemiology of childhood depressive disorders: a critical review. J Am Acad Child Adolesc Psychiatry 1990; 29: 571-80
6. McGee R, Feehan M, Williams S, et al. DSM-III disorders from age 11 to age 15 years. J Am Acad Child Adolesc Psychiatry 1992; 31: 50-9
7. Shaffer D, Garland A, Vieland V, et al. The impact of curriculum-based suicide prevention, programs for teenagers. J Am Acad Child Adolesc Psychiatry 1991; 30: 588-96
8. Brent DA, Perper J, Moritz G, et al. Psychiatric risk factors for adolescent suicide: a case control study. J Am Acad Child Adolesc Psychiatry 1993; 32: 521-9
9. Shafii M, Steltz-Lenarsky J, Derrick AM, et al. Comorbidity of mental disorders in the post-mortem diagnosis of completed suicide in children and adolescents. J Affect Disord 1988; 15: 277-83
10. Marttunen M, Aro H, Henriksson M, et al. Mental disorder in adolescent suicide: DSM-III-R axes I and II among 13 to 19 year olds in Finland. Arch Gen Psychiatry 1991; 48: 834-9
11. Rich CL, Young D, Fowler RC. San Diego suicide study I: young vs old subjects. Arch Gen Psychiatry 1986; 43: 577-82
12. De Wilde EJ. Adolescent suicidal behaviour: a general population perspective. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 249-73
13. Lewinsohn PM, Rohde P, Seeley JR. Treatment of adolescent depression: frequency of services and impact on functioning in young adulthood. Depress Anxiety 1998; 7: 47-52
14. Flament MF, Cohen D, Choquet M, et al. Phenomenology, psychosocial correlates and treatment seeking in major depression and dysthymia of adolescence. J Am Acad Child Adolesc Psychiatry 2001; 40: 1070-8
15. Shaffer D, Gould MS, Fisher P, et al. Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry 1996; 53: 339-48
16. Appleby L, Cooper J, Amos T, et al. Psychological autopsy of suicides by people under 35. Br J Psychiatry 1999; 175: 168-74
17. Shaffer D, Fisher P. The epidemiology of suicide in children and adolescents. J Am Acad Child Adolesc Psychiatry 1981; 20: 545-65
18. Shaffer D. Suicide in childhood and adolescence. J Child Psychol Psychiatry 1974; 15: 275-91
19. Aro H, Marttunen M, Lönnqvist J. Adolescent development and youth suicide. Suicide Life Threat Behav 1993; 23: 359-65
20. Brent DA, Moritz G. Developmental pathways to adolescent suicide. In: Cicchetti D, Toth SL, editors. Adolescence: opportunities and challenges. Rochester symposium on developmental psychopathology. Vol. 7. New York: University of Rochester Press, 1996: 233-58.
21. Angold A. Costello EJ, Worthman CM. Puberty and depression: the roles of age, pubertal status and pubertal timing. Psychol Med 1998; 28: 51-61
22. Cicchetti D, Toth SL. The development of depression in children and adolescents. Am Psychol 1998; 53: 221-41
23. Harrington R, Rutter M, Fombonne E. Developmental pathways in depression: multiple meanings, antecedents and endpoints. Dev Psychopathol 1996; 8: 601-16
24. Rao U, Weissman MM, Martin JA, et al. Childhood depression and risk of suicide: a preliminary report of a longitudinal study. J Am Acad Child Adolesc Psychiatry 1993; 32: 21-7
25. Fergusson DM, Woodward LJ, Horwood LJ. Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychol Med 2000; 30: 23-39
26. Deavoll BJ, Mulder RT, Beautrais AL, et al. One hundred years of suicide in New Zealand. Acta Psychiatr Scand 1993; 87: 81-5
27. Hider P. Youth suicide prevention by primary healthcare professionals: a critical appraisal of the literature. NZHTA report. Christchurch: Christchurch School of Medicine, 1998: 4
28. Värnik A. Suicide in Estonia. Acta Psychiatr Scand 1991; 84: 229-32
29. Allebeck P, Brandt L, Nordström P, et al. Are suicide trends among the young reversing: age, period and cohort analyses of suicide rates in Sweden. Acta Psychiatr Scand 1996; 93: 3-48
30. American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with suicidal behavior. J Am Acad Child Adolesc Psychiatry 2001; 40 Suppl. 7: 24-51S
31. Brent DA, Baugher M, Bridge J, et al. Age- and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatry 1999; 38: 1497-505
32. Lönnqvist J. Suicide mortality in Finland declined by 21% from 1990 to 1998 [editorial]. Psychiatr Fenn 2000; 31: 5
33. Gould MS, Kramer RA. Youth suicide prevention. Suicide Life Threat Behav 2001; 31 Suppl. 1: 6-31
34. Cheng ATA, Lee C-S. Suicide in Asia and the Far East. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 29-48
35. Pritchard C. Suicide in the People's Republic of China categorized by age and gender: evidence of the influence of culture on suicide. Acta Psychiatr Scand 1996; 93: 362-7
36. Värnik A, Wasserman D. Suicides in the former Soviet republics. Acta Psychiatr Scand 1992; 86: 76-8
37. Ramstedt M. Alcohol and suicide in 14 European countries. Addiction 2001; 96 Suppl. 1: S59-75
38. Cantor CH. Suicide in the western world. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 9-28
39. Hawton K, Appleby L, Platt S, et al. The psychological autopsy approach to studying suicide: a review of methodological issues. J Affect Disord 1998; 50: 269-76
40. Marttunen M, Aro H, Lönnqvist J. Research on mental disorders in adolescent suicide. In: Crepet P, Ferrari G. Platt S, et al., editors. Suicidal behaviour in Europe: recent research findings. Rome: John Libbey CIC, 1992: 253-9
41. Kelly TM, Mann JJ. Validity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis. Acta Psychiatr Scand 1996; 94: 337-43
42. Gould MS, Shaffer D, Fisher P, et al. The clinical prediction of suicide. In: Maris RW, Berman AL, Maltsberger JT, et al., editors. Assessment and prediction of suicide. New York: Guilford, 1992: 130-43
43. Brent DA. Risk factors for adolescent suicide and suicidal behavior: mental and substance abuse disorders, family environmental factors, and life stress. Suicide Life Threat Behav 1995; 25: 52-63
44. Brent DA, Perper JA, Goldstein CE, et al. Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients. Arch Gen Psychiatry 1988; 45: 581-8
45. Shafii M, Carrigan S, Whittinghill JR, et al. Psychological autopsy of completed suicide in children and adolescents. Am J Psychiatry 1985; 142: 1061-4
46. Brent DA, Perper JA, Moritz G, et al. Familial risk factors for adolescent suicide: a case-control study. Acta Psychiatr Scand 1994; 89: 52-8
47. Apter A, Bleich A, King RA, et al. Death without warning: a clinical postmortem study of suicide in 43 Israeli adolescent males. Arch Gen Psychiatry 1993; 50: 138-42
48. Nylander I. A 20-year prospective follow-up study of 2164 cases in the child-guidance clinics in Stockholm. Acta Paediatr Scand 1979; Suppl. 276: 179-276
49. de Chateau P. Mortality and aggressiveness in a 30-year follow-up study in child guidance clinics in Stockholm. Acta Psychiatr Scand 1990; 82: 472-6
50. Rydelius P-A. Deaths among child and adolescent psychiatric patients. Acta Psychiatr Scand 1984; 70: 119-26
51. Enqvist U, Rydelius P-A. Hur går det för barn- och ungdomspsykiatrins patienter. Samverkan krävs mellan pediatrik, barn- och vuxen psykiatri. Läkartidningen 2000; 97: 2856-61
52. Pelkonen M, Marttunen M, Pulkkinen E, et al. Excess mortality among former adolescent male outpatients. Acta Psychiatr Scand 1996; 94: 60-6
53. Gould MS, Fisher P, Parides M, et al. Psychosocial risk factors of child and adolescent completed suicide. Arch Gen Psychiatry 1996; 53: 1155-62
54. Groholt B, Ekeberg O, Wichstom L, et al. Youth suicide in Norway, 1990-1992: a comparison between children and adolescents completing suicide and age- and gender-matched controls. Suicide Life Threat Behav 1997; 27: 250-63
55. Brent DA, Bridge J, Johnson BA, et al. Suicidal behavior runs in families: a controlled family study of adolescent suicide victims. Arch Gen Psychiatry 1996; 53: 1145-52
56. Marttunen M, Aro H, Henriksson M, et al. Antisocial behaviour in adolescent suicide. Acta Psychiatr Scand 1994; 89: 167-73
57. Lesage AD, Boyer R, Grunberg F, et al. Suicide and mental disorders: a case-control study of young men. Am J Psychiatry 1994; 151: 1063-8
58. Marttunen M, Pelkonen M. Psychiatric risk factors for adolescent suicide: a review. Psychiatr Fenn 2000; 31: 110-25
59. Marttunen M, Henriksson M, Aro H, et al. Suicide among female adolescents: characteristics and comparison with males in the age group 13 to 22 years. J Am Acad Child Adolesc Psychiatry 1995; 34: 1297-307
60. Pirkola SP, Marttunen MJ, Henriksoon MM, et al. Alcohol-related problems among adolescent suicides in Finland. Alcohol Alcohol 1999; 34: 320-9
61. Isometsä E, Henriksson M, Marttunen M, et al. Mental disorders in young adult and middle-aged men who commit suicide. BMJ 1995; 310: 1366-7
62. Runeson B. Mental disorders in youth suicide: DSM-III-R axes I and II. Acta Psychiatr Scand 1989; 79: 490-7
63. Renaud J, Brent DA, Birmaher B, et al. Suicide in adolescents with disruptive disorders. J Am Acad Child Adolesc Psychiatry 1999; 38: 846-51
64. Thompson TR. Childhood and adolescent suicide in Manitoba: a demographic study. Can J Psychiatry 1986; 32: 264-9
65. Runeson B. Psychoactive substance use disorder in youth suicide. Alcohol Alcohol 1990; 25: 561-8
66. Marttunen M, Aro H, Lönnqvist J. Adolescent suicide: endpoint of long-term difficulties. J Am Acad Child Adolesc Psychiatry 1992; 31: 649-54
67. Nylander I, Hellström LH, Möllerström K. Mortality among boys reported to the Stockholm child and youth welfare committee. Acta Paedopsychiatr 1966; 33: 315-21
68. Pelkonen M. Inpatient psychiatric adolescents function better than expected after discharge: a follow-up study. Acta Psychiatr Scand 1990; 81: 317-21
69. Welner A, Welner Z, Fishman R. Psychiatric adolescent inpatients: eight- to ten-year follow-up. Arch Gen Psychiatry 1979; 36: 698-700
70. Goldacre M, Hawton K. Repetition of self-poisoning and subsequent death in adolescents who take overdoses. Br J Psychiatry 1985; 146: 395-8
71. Otto U. Suicidal acts by children and adolescents: a follow-up study. Acta Psychiatr Scand Suppl 1972; 233: 7-123
72. Rorsman B. Mortality among psychiatric patients. Acta Psychiatr Scand 1974; 50: 354-75
73. Motto JA. Suicide in male adolescents. In: Sudak HS, Ford AB, Rushforth NB, editors. Suicide in the young. Boston (MA): John Wright, 1984: 227-44
74. Kuperman S, Black DW, Burns TL. Excess mortality among formerly hospitalized child psychiatric patients. Arch Gen Psychiatry 1988; 45: 277-82
75. Larsen FW. A 30-year follow-up study of a child psychiatric clientele: II, psychiatric morbidity. Acta Psychiatr Scand 1991; 84: 65-71
76. Kjelsberg E, Neegaard E, Dahl AA. Suicide in adolescent psychiatric inpatients: incidence and predictive factors. Acta Psychiatr Scand 1994; 89: 235-41
77. Kjelsberg E, Sandvik L, Dahl AA. A long-term follow-up study of adolescent psychiatric inpatients: Part I, predictors of early death. Acta Psychiatr Scand 1999; 99: 231-6
78. Sellar C, Hawton K, Goldacre M. Self-poisoning in adolescents: hospital admissions and deaths in the Oxford region 1980-85. Br J Psychiatry 1990; 156: 866-70
79. Kotila L, Lönnqvist J. Suicide and violent death among adolescent suicide attempters. Acta Psychiatr Scand 1989; 79: 453-9
80. Hawton K, Fagg J, Platt S, et al. Factors associated with suicide after parasuicide in young people. BMJ 1993; 306: 1641-4
81. Granboulan V, Rabain D, Basquin M. The outcome of adolescent suicide attempts. Acta Psychiatr Scand 1995; 91: 265-70
82. Laurent A, Foussard N, David M, et al. A 5-year follow-up study of suicide attempts among French adolescents. J Adolesc Health 1998; 22: 424-30
83. Allebeck P, Allgulander C, Fisher LD. Predictors of completed suicide in a cohort of 50465 young men: role of personality and deviant behaviour. BMJ 1988; 297: 176-8
84. Groholt B, Ekeberg O, Wichstom L, et al. Suicide among children and younger and older adolescents in Norway: a comparative study. J Am Acad Child Adolesc Psychiatry 1998; 37: 473-81
85. Beautrais AL. Risk factors for suicide and attempted suicide among young people. In: National Youth Suicide Prevention Strategy: setting the evidence-based research agenda for Australia. Canberra: Department of Health and Aged Care, Commonwealth of Australia, 1999: 113-278
86. Schmidtke A, Bille-Brahe U, DeLeo D, et al. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand 1996; 93: 327-38
87. Joffe RT, Offord DR, Boyle MH. Ontario Child Health Study: suicidal behavior in youth age 12-16 years. Am J Psychiatry 1988; 145: 1420-3
88. Reinherz HZ, Giaconia RM, Silverman AB, et al. Early psychosocial risks for adolescent suicidal ideation and attempts. J Am Acad Child Adolesc Psychiatry 1995; 34: 599-611
89. Fergusson DM, Lynskey MT. Childhood circumstances, adolescent adjustment and suicide attempts in a New Zealand birth cohort. J Am Acad Child Adolesc Psychiatry 1995; 34: 612-22
90. Beautrais AL, Joyce PR, Mulder RT. Risk factors for serious suicide attempts among youths aged 13 through 24 years. J Am Acad Child Adolesc Psychiatry 1996; 35: 1174-82
91. Beautrais AL, Joyce PR, Mulder RT. Youth suicide attempts: a social and demographic profile. Aust N Z J Psychiatry 1998; 32: 349-57
92. Wichstrom L. Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents. J Am Acad Child Adolesc Psychiatry 2000; 39: 603-10
93. Lewinsohn PM, Rohde P, Seeley JR. Psychosocial risk factors for future adolescent suicide attempts. J Consult Clin Psychol 1994; 62: 297-305
94. Potter LB, Kresnow M, Powell KE, et al. The influence of geographic mobility on nearly lethal suicide attempts. Suicide Life Threat Behav 2001; 32 (1 Suppl.): 42-8
95. Garnefski N, Arends E. Sexual abuse and adolescent maladjustment: difference between male and female victims. J Adolesc 1998; 21: 99-107
96. Gould MS, King R, Greenwald S, et al. Psychopathology associated with suicidal ideation and attempts among children and adolescents. J Am Acad Child Adolesc Psychiatry 1998; 37: 915-23
97. Kingsbury S, Hawton K, Steinhardt K, et al. Do adolescents who take overdoses have specific psychological characteristics: a comparative study with psychiatric and community controls. J Am Acad Child Adolesc Psychiatry 1999; 38: 1125-31
98. Groholt B, Ekeberg O, Wichstrom L, et al. Young suicide attempters: a comparison between a clinical and an epidemiological sample. J Am Acad Child Adolesc Psychiatry 2000; 39: 868-75
99. Pelkonen M, Marttunen M, Pulkinen E, et al. Characteristics of outpatient adolescents with suicidal tendencies. Acta Psychiatr Scand 1997; 95: 100-7
100. Patton G, Burns J. Preventive interventions for youth suicide: a risk factor-based approach. In: National Youth Suicide Prevention Strategy: setting the evidence-based research agenda for Australia. Canberra: Department of Health and Aged Care, 1999: 279-391
101. WHO. Preventing suicide. A resource for general physicians: mental and behavioural disorders. Geneva: Department of Mental Health, World Health Organization, 2000
102. Taylor SJ, Kingdom D, Jenkins R. How are nations trying to prevent suicide: an analysis of national suicide prevention strategies. Acta Psychiatr Scand 1997; 95: 457-63
103. Upanne M, Hakanen J, Rautava M. Can suicide be prevented: the suicide project in Finland 1992-1996. Goals, implementation and evaluation. Saarijärvi: National Research and Development Centre for Welfare and Health, 1999
104. Jenkins R, Singh B. General population strategies of suicide prevention. In: Hawton K, van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: John Wiley & Sons Ltd, 2000: 597-615
105. King KA. Developing a comprehensive school suicide prevention program. J Sch Health 2001; 71: 132-7
106. Berman AL, Jobes DA. Suicide prevention in adolescents (age 12-18). Suicide Life Threat Behav 1995; 25: 143-54
107. Vieland V, Whittle B, Garland A, et al. The impact of curriculum-based suicide prevention programs for teenagers: an 18-month follow-up. J Am Acad Child Adolesc Psychiatry 1991; 30: 811-5
108. Shaffer D, Craft L. Methods of adolescent suicide prevention. J Clin Psychiatry 1999; 60 Suppl. 2: 70-4
109. Shaffer D, Vieland V, Garland A, et al. Adolescent suicide attempters: response to suicide-prevention programs. JAMA 1990; 264: 3151-5
110. Offer D, Howard KI, Schonert KA, et al. To whom do adolescents turn for help: differences between disturbed and nondisturbed adolescents. J Am Acad Child Adolesc Psychiatry 1991; 30: 623-30
111. Johnson GR, Krug EG, Potter LB. Suicide among adolescents and young adults: a cross-national comparison of 34 countries. Suicide Life Threat Behav 2000; 30: 74-82
112. Brent DA. Correlates of the medical lethality of suicide attempts in children and adolescents. J Am Acad Child Adolesc Psychiatry 1987; 26: 87-9
113. Carrington PJ, Moyer S. Gun control and suicide in Ontario. Am J Psychiatry 1994; 151: 606-8
114. Rich CL, Young JG, Fowler RC, et al. Guns and suicide: possible effects of some specific legislation. Am J Psychiatry 1990; 147: 342-6
115. Kruesi MJ, Grossman J, Pennington JM, et al. Suicide and violence prevention: parent education in the emergency department. J Am Acad Child Adolesc Psychiatry 1999; 38: 250-5
116. Gunnell D, Murray V, Hawton K. Use of paracetamol (acetaminophen) for suicide and nonfatal poisoning: worldwide patterns of use and misuse. Suicide Life Threat Behav 2000; 30: 313-26
117. Ohberg A, Lonnqvist J, Sarna S, et al. Violent methods associated with high suicide mortality among the young. J Am Acad Child Adolesc Psychiatry 1996; 35: 144-53
118. Beautrais AL. Methods of youth suicide in New Zealand: trends and implications for prevention. Aust N Z J Psychiatry 2000; 34: 413-9
119. Gould MS, Wallenstein S, Kleinman M, et al. Suicide clusters: an examination of age-specific effects. Am J Public Health 1990; 80: 211-2
120. Poijula S, Walhberg K-E, Dyregrov A. Adolescent suicide and suicide contagion in three secondary schools. Int J Emerg Ment Health 2001; 3: 169-75
121. Appleby L, Amos T, Doyle U, et al. General practitioners and young suicides: a preventive role for primary care. Br J Psychiatry 1996; 168: 330-3
122. Isometsä E, Heikkinen M, Marttunen M, et al. The last appointment before suicide: is suicidal intent communicated. Am J Psychiatry 1995; 152: 919-22
123. Barnes LS, Ikeda RM, Kresnow M. Help-seeking behavior prior to nearly lethal suicide attempts. Suicide Life Threat Behav 2001; 32 (1 Suppl.): 68-75
124. Jacobsen LK, Rabinowitz I, Popper MS, et al. Interviewing prepubertal children about suicidal ideation and behavior. J Am Acad Child Adolesc Psychiatry 1994; 33: 439-52
125. Mishara BL. Conceptions of death and suicide in children ages 6-12 and their implications for suicide prevention. Suicide Life Threat Behav 1999; 29: 105-18
126. Reynolds WM. A school-based procedure for the identification of adolescents at risk for suicidal behaviors. Fam Community Health 1991; 14: 64-75
127. Thompson EA, Eggert LL. Using the suicide risk screen to identify suicidal adolescents among potential high school dropouts. J Am Acad Child Adolesc Psychiatry 1999; 38: 1506-14
128. Shaffer D, Craft L. Methods of adolescent suicide prevention. J Clin Psychiatry 1999; 60 Suppl. 2: 70-4
129. Birmaher B, Ryan ND, Williamson DE, et al. Childhood and adolescent depression: a review of the past 10 years: part II. J Am Acad Child Adolesc Psychiatry 1996; 35: 1575-83
130. American Academy of Child and Adolescent Psychiatry. Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 1998; 37 Suppl. 10: 63-83S
131. Harrington R, Whittaker J, Shoebridge P. Psychological treatment of depression in children and adolescents: a review of treatment research. Br J Psychiatry 1998; 173: 291-8
132. Lewinsohn PM, Clarke GN, Hops H, et al. Cognitive-behavioral treatment for depressed adolescents. Behav Ther 1990; 21: 385-401
133. Reed MK. Social skills training to reduce depression in adolescents. Adolescence 1994; 29: 293-302
134. Vostanis P, Harrington R. Cognitive-behavioural treatment of depressive disorder in child psychiatric patients: rationale and description of treatment package. Eur Child Adolesc Psychiatry 1994; 3: 111-23
135. Wood A, Harrington R, Moore A. Controlled trial of a brief cognitive-behavioural intervention in adolescent patients with depressive disorders. J Child Psychol Psychiatry 1996; 37: 737-46
136. Brent DA, Holder D, Kolko D, et al. A clinical psychotherapy trial for adolescent depression comparing cognitive, family, and supportive therapy. Arch Gen Psychiatry 1997; 54: 877-85
137. Clarke GN, Rohde P, Lewinsohn PM, et al. Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. J Am Acad Child Adolesc Psychiatry 1999; 38: 272-9
138. Mufson L, Weissman MM, Moreau D, et al. Efficacy of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry 1999; 56: 573-9
139. Rossello J, Bernal G. The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. J Consult Clin Psychol 1999; 67: 734-45
140. Fine S, Forth A, Gilbert M, et al. Group therapy for adolescent depressive disorder: a comparison of social skills and therapeutic support. J Am Acad Child Adolesc Psychiatry 1991; 30: 79-85
141. Target M, Fonagy P. Efficacy of psychoanalysis for children with emotional disorders. J Am Acad Child Adolesc Psychiatry 1994; 33: 361-71
142. Hazell P, O'Connell D, Heathcote D, et al. Tricyclic drugs for depression in children and adolescents [review]. Available in The Cochrane Library [database on CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 1. Oxford: Update Software, 2001
143. Renaud J, Axelson D, Birmaher B. A risk-benefit assessment of pharmacotherapies for clinical depression in children and adolescents. Drug Saf 1999; 20: 59-75
144. Simeon J, Dinicola V, Ferguson H, et al. Adolescent depression: a placebo controlled fluoxetine treatment study and follow-up. Prog Neuropsychopharmacol Biol Psychiatry 1990; 14: 791-5
145. Emslie GJ, Rush J, Weinberg WA, et al. A double-blind randomized placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry 1997; 54: 1031-7
146. Keller MB, Ryan ND, Strober M, et al. Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 2001; 40: 762-72
147. Mandoki MW, Tapia MR, Tapia MA, et al. Venlafaxine in the treatment of children and adolescents with major depression. Psychopharmacol Bull 1997; 33: 149-54
148. Findling RL, Reed MD, Blumer JL. Pharmacological treatment of depression in children and adolescents. Paediatr Drugs 1999; 1: 161-82
149. Strober M, DeAntonio M, Schmidt-Lackner S, et al. The pharmacotherapy of depressive illness in adolescents: an open-label comparison of fluoxetine with imipramine- treated historical controls. J Clin Psychiatry 1999; 60: 164-9
150. Geller B, Luby J. Child and adolescent bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 1997; 36: 1168-76
151. Geller B, Cooper TB, Sun K. Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry 1998; 37: 171-8
152. Rey JM, Walter G. Half a century of ECT use in young people: a review. Am J Psychiatry 1997; 154: 595-602
153. Harrington R, Whittaker J, Shoebridge P, et al. Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. BMJ 1998; 316: 1559-63
154. Reinecke MA, Ryan NE, DuBois DL. Cognitive-behavioral therapy of depression and depressive symptoms during adolescence: a review and meta-analysis. J Am Acad Child Adolesc Psychiatry 1998; 37: 26-34
155. Hulten A, Wasserman D. Lack of continuity: a problem in the care of young suicides. Acta Psychiatr Scand 1998; 97: 326-33
156. Lewinsohn P, Rohde P, Seeley JR. Psychosocial characteristics of adolescents with a history of suicide attempt. J Am Acad Child Adolesc Psychiatry 1993; 32: 60-8
157. Marttunen M, Aro H, Lönnqvist J. Adolescence and suicide: a review of psychological autopsy studies. Eur J Child Adolesc Psychiatry 1993; 2: 10-8
158. Piacentini J, Rotheram-Borus MJ, Gillis JR, et al. Demographic predictors of treatment attendance among adolescent suicide attempters. J Consult Clin Psychol 1995; 63: 469-73
159. Pelkonen M, Marttunen M, Laippala P, et al. Factors associated with early dropout from adolescent psychiatric outpatient treatment. J Am Acad Child Adolesc Psychiatry 2000; 39: 329-36
160. Granboulan V, Roudot-Thoraval F, Lemerle S, et al. Predictive factors of post-discharge follow-up care among adolescent suicide attempters. Acta Psychiatr Scand 2001; 104: 31-6
161. Hawton K, Townsend E, Arensman E, et al. Psychosocial and pharmacological treatments for deliberate self harm. Available in the Cochrane Library [database on CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 1. Oxford: Update Software, 2001
162. Miller AL, Rathus JH, Linehan MM, et al. Dialectical behavior therapy adapted for suicidal adolescents. J Pract Psychiatry Behav Health 1997; 3: 78-86
163. Deykin EY, Hsieh C-C, Joshi N, et al. Adolescent suicidal and self-destructive behavior: results of an intervention study. J Adolesc Health Care 1986; 7: 88-95
164. Lerner MS, Clum GA. Treatment of suicide ideators: a problem-solving approach. Behav Ther 1990; 21: 403-11
165. Cotgrove AJ, Zirinsky L, Black D, et al. Secondary prevention of attempted suicide in adolescence. J Adolesc 1995; 18: 569-77
166. Donaldson D, Spirito A, Arrigan M, et al. Structured disposition planning for adolescent suicide attempters in a general hospital: preliminary findings on short-term outcome. Arch Suicide Res 1997; 3: 271-82
167. Spirito A, Boergers J, Donaldson D, et al. An intervention trial to improve adherence to community treatment by adolescents after a suicide attempt. J Am Acad Child Adolesc Psychiatry 2002; 41: 435-42
168. Harrington R, Kerfoot M, Dyer E, et al. Randomized trial of a home-based family intervention for children who have deliberately poisoned themselves. J Am Acad Child Adolesc Psychiatry 1998; 37: 512-8
169. Rotheram-Borus MJ, Piacentini J, Cantwell C, et al. The 18-month impact of an emergency room intervention for adolescent female suicide attempters. J Consult Clin Psychol 2000; 68: 1081-93
170. Wood A, Trainor G, Rothwell J, et al. Randomised trial of group therapy for repeated deliberate self-harm in adolescents. J Am Acad Child Adolesc Psychiatry 2001; 40: 1246-53
171. Mann JJ. The neurobiology of suicide. Nat Med 1998; 4: 25-30
172. Mann JJ, Underwood MD, Arango V. Postmortem studies of suicide victims. In: SJ Watson, editor. Biology of schizophrenia and affective disease. Washington, DC: American Psychiatric Press Inc, 1996: 197-220
173. Mann JJ, Stoff DM. A synthesis of current findings regarding neurobiological correlates and treatment of suicidal behavior. Ann N Y Acad Sci 1997; 836: 352-63
174. Verkes RJ, van der Mast RC, Hengeveld MW, et al. Reduction by paroxetine of suicidal behavior in patients with repeated suicide attempts but not major depression. Am J Psychiatry 1998; 155: 543-7
175. Montgomery SA, Roy D, Montgomery DB. The prevention of recurrent suicidal acts. Br J Clin Pharmacol 1983; 15: 183-188S
176. Tondo L, Hennen J, Baldessarini RJ. Lower suicide risk with long-term lithium treatment in major affective illness: a meta-analysis. Acta Psychiatr Scand 2001; 104: 163-72
177. Poijula S, Dyregrov A, Wahlberg KE, et al. Reactions to adolescent suicide and crisis intervention in three secondary schools. Int J Emerg Ment Health 2001; 3: 97-106
178. Brent DA, Perper JA, Moritz G, et al. Major depression or uncomplicated bereavement: a follow-up of youth exposed to suicide. J Am Acad Child Adolesc Psychiatry 1994; 33: 231-9
179. Brent DA, Moritz G, Bridge J, et al. Long-term impact of exposure to suicide: a three-year controlled follow-up. J Am Acad Child Adolesc Psychiatry 1996; 35: 646-5