Source: The Lancet (UK) Volume 352, Number 9126 Contact: Website: http://www.thelancet.com/ Pubdate: Sat, 08 Aug 1998 Author: Kelly Morris INCREASE IN TEEN BOYS' SUICIDAL BEHAVIOUR LINKED WITH ALCOHOL MISUSE Suicidal behaviours (ideas, attempts, or threats) are increasing in adolescent boys, and data suggest that "alcohol misuse is the causal factor", says Eric Fombonne (Institute of Psychiatry, London, UK). If these time trends are confirmed in population-based studies, these findings suggest targets for suicide prevention, he adds. To investigate the underlying factors for increasing suicide rates, Fombonne studied a data set of all 6091 children aged 8-18 years referred to south London psychiatric services between 1970 and 1990. Suicidal behaviours--a strong risk factor for suicide--increased over the 21-year period in adolescent boys, but not in prepubertal boys or in girls of any age. Logistic regression analysis revealed that substance misuse increased contemporaneously in adolescent boys, and was the only such factor predictive of suicidal behaviours (odds ratio [OR] 3B75, 95% CI 1B79-6B72). By contrast, depression was a strong correlate of suicidal behaviours but did not increase over time, and family breakdown, which did increase markedly, was not predictive of suicidal behaviours (Br J Psych 1998; 173: 154-59). A review of randomly selected case notes found that alcohol was the most frequently misused substance among the teenagers, and that "alcohol misuse was the only behaviour showing both an increase over the study period and a strong and positive association with suicidality". Furthermore, severity of suicidal behaviours (attempts vs ideas or plans) was significantly associated with alcohol misuse (OR 4B72, 95% CI 1B73-13B73). When considered with other studies, these data suggest that alcohol misuse may be the underlying cause behind the increase in youth suicidal behaviours, says Fombonne, adding that psychiatrists should screen adolescent boys for substance use, and educate vulnerable patients about "the detrimental effects of alcohol misuse". - --- Checked-by: Richard Lake