Suicide Attempts in Adolescents

Abstract

objectives of the present study were to assess the prevalence of suicidal ideation and behaviour among Swiss teenagers and to determine which factors are associated with suicide attempts. Material and methods The data presented here are derived from the Swiss Multicenter Adolescent Survey on Health, and a detailed description of the methodology is given elsewhere (18). This national survey was conducted in the three different linguistic regions of Switzerland during the years 1992 and 1993. A representative sample of 9268 in-school adolescents, aged 15 to 19 years, stratified according to educational background , grade and region, filled in an anonymous self-administered questionnaire. In Switzerland, it is estimated that about 90% of 15-to 19-year-old teenagers can be reached through such a school survey (18). The questionnaire was presented by professionals external to the school, in order to ensure confidentiality. It included 80 questions targeting health attitudes and behaviours, health care utilization and lifestyle. Most of the questions were derived from similar surveys and had been discussed and approved by a group of professionals and adolescents. One 6-item question focused on suicidal ideation and behaviour. This question was adapted from a similar one in the Center for Disease Control (CDC) Youth Risk Behaviour Survey (19). It included two items pertaining to suicidal thoughts, two items pertaining to suicidal plans (intention to kill oneself), one item on suicide among relatives/ friends, and one item focusing on suicide attempts, with a sub-item investigating the actual disclosure of this act to relatives or friends. Unlike the CDC survey, the investigation was limited to the last 12 months. The assessment was limited to the preceding year in order to minimize recall biases. Another part of the questionnaire contained questions on health care utilization and asked whether the theme of suicide had been discussed with the adolescent's physician or with other professionals. Using an SPSS datafile, we first performed univari-ate analyses to establish frequencies by sex, age and educational background. We then compared suicide attempters with adolescents who were free of suicidal concerns. As the differences between these two groups were statistically significant for more than 60 variables, we performed a multiple logistic regression involving all of these variables, in order to select those with the highest discriminating value. Results