Friday, September 7, 2007

Suicide Rates Rise In Youth

From our discussions earlier in the semester, you'll remember that suicide rates amongst teenagers and young adults (10.5/100,000 for 15-24, 8.0 for 15-19 year olds) are lower than most of the adult and elderly populations. Which is why news that a "spike" in the suicide rate amongst juveniles and young adults (particularly among juvenile females age 10-14), comes as such a surprise.

According to the CDC report, the rate of suicide in Americans ages 10 to 24 increased 8 percent from 2003 to 2004, the largest jump in more than 15 years. From 1990 to 2003, the rate fell by more than 28 percent, from 9.48 to 6.78 suicides per 100,000 young people. From 2003 to 2004, the rate jumped back up to 7.32 per 100,000. For juvenile females aged 10--14 years, the increase in suicide in 2004 was 75.9%.

Interestingly, while firearms and poisonings have been the preferred method of suicide amongst juveniles (yet the rates had been declining since the 1990's), the method now most commonly used by adolescents is hanging. "In 2004, hanging/suffocation was the most common method among females in all three age groups, accounting for 71.4% of suicides in the group aged 10--14 years, 49% in the group aged 15--19 years, and 34.2% in the group aged 20--24 years."

In my opinion, this represents the most troubling statistic released in the report, and calls for renewed research into the changing methodology of suicide amongst females. Hangings/suffocations have always been a relatively common method of suicide (second or third, behind guns) yet it was almost always the purvey of males. This would make a major change in the act for juvenile females in particular.

But the real debate in the media seems to focus on the role (or lack thereof) of psychotropic medications and adolescence. In a study first reported last year and "published Wednesday in The American Journal of Psychiatry, an international team of researchers found that a decrease in antidepressant prescriptions to minors of just a few percentage points coincided with a 14 percent spike in suicides in the United States."

They also note that the increase in suicide from 2003-2004 coincides with a change in the way the FDA regulated psychotropic medications for adolescence (essentially making it more difficult for teens to acquire these medications). According to these researchers, because teenagers are receiving fewer prescriptions for anti-depressants, we are now seeing an increase in suicide.

However, to suggest that fewer prescriptions has led to an increase in suicide is speculative at best. "You simply cannot reach causal conclusions,” says Dr. Thomas Laughren, director of the division of psychiatry products at the F.D.A. In fact, some psychiatrists and behaviorists argue that prescription psychotropic medications may actually be contributing to suicidal ideation.

Because suicide is such a multi-faceted phenomenon, it will be difficult to untangle the relationship between medications and suicide. We'll discuss Labeling Theory and the prevalence of psychotropics amongst children and adolescents later in the semester, but suffice it to say at this point, any increase in suicide amongst any group is troubling for all of society.

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