In updated clinical report, American
Academy of Pediatrics highlights the role bullying, internet use and other
factors play in adolescent suicide.
Elk Grove Village, IL - With suicide rising to the second-leading cause of death among
adolescents, the American Academy of Pediatrics (AAP) is publishing updated
guidelines advising pediatricians how to identify and help teens at risk.
In a clinical report, “Suicide and Suicide Attempts in Adolescents
” in the July 2016 Pediatrics (published online
June 27), the AAP urges pediatricians to screen patients for suicidal thoughts
and identifies risk factors linked to teen suicide attempts, such as bullying
and pathological internet use.
The report replaces a previous version
that was published in 2007. At that time, suicide was the third-leading cause
of death for adolescents 15 to 19 years old; now it is second, having passed up
homicide. Only unintentional injuries, such as motor vehicle crashes and
inadvertent poisonings, claim the lives of more teens.
According to the AAP, risk factors for
suicide attempts include a family history of suicide, a history of physical or
sexual abuse, mood disorders, drug and alcohol use, and lesbian, gay, bisexual
or questioning sexual orientation or transgender identification. An important
additional risk factor for suicide is bullying.
has always been a major issue for adolescents, but there is now greater
recognition of the connection between bullying and suicide,” said the AAP
report’s lead author, Benjamin Shain, MD, PhD.
“The Internet is a key influence, as
well. Cyberbullying, for example, is as serious a problem as face-to-face
bullying,” said Dr. Shain, a child psychiatrist with NorthShore University
Internet use that exceeds 5 hours a day
is linked to higher levels of depression and suicidal thoughts among
adolescents, although the Internet may also be an important source of support
for them. Adolescents are also at higher risk of suicide attempts if they have
a strained parent-child relationship, live outside the home, have difficulties
in school or are not attending school. Protective factors cited include
religious involvement and connection between the youth and parents, school, and
Suicide rates vary based on race and
gender, according to the clinical report. Girls make more suicide attempts, but
boys die from suicide at a rate three times higher than girls because they tend
to choose more lethal methods, such as firearms. Firearms in the home are a
particular danger, according to the AAP, with studies showing the risk of
suicide is 4 to 10 times higher in homes with guns than in those without. The AAP recommends
any firearm be kept locked up, with the ammunition stored separately.
But however they are stored, firearms in
the home are associated with a high risk of adolescent suicide. The AAP
recommends that parents of adolescents at risk for suicide remove guns and
ammunition from the house.
The AAP recommends pediatricians
routinely ask adolescent patients if they have thoughts of harming themselves,
and screen for other factors associated with increased suicide risk.
Pediatricians should refer patients for appropriate mental health evaluation
and treatment when needed. Antidepressants medications are a valuable treatment
option, according to the AAP. Since “black box” warning labels were added to
antidepressants in 2004, new research has indicated that the benefits of these
medications outweigh the risks for many patients.
The American Academy of Pediatrics is an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org