[Suicidal behavior and suicide attempts in adolescents and young adults--epidemiology, risk factors, prevention and treatment]

Abstract

According to WHO, every year, suicide is committed by at least 1 mln people in the world. In Europe, suicide is committed by about 43 thousand people a year, most frequently by middle-aged and elderly males, and attempted by 700 thousand people. In Poland, in 2002, 5100 people committed suicide. The number of suicide attempts is probably ten times higher. The aim of the study is to investigate the current state of knowledge concerning suicidal behaviour and attempted suicide in adolescents and young adults. The literature on the subject is analysed, and special attention is paid to the issue of suicide epidemiology, risk factors, prevention and treatment. Definitions of suicidal behaviour and presuicidal syndrome are debated. In the chapter concerning treatment, Bohme's model of crisis intervention in the case of suicidal patients is discussed, and detailed indications for treatment are presented. Suicide attempts are undertaken most frequently by young people, especially by teenage girls and young women. The ratio of suicide in this age group increased significantly in the last few years. Phenomena which are of special importance for the prevention of suicide among adolescents include suicidal thoughts, attempted suicide, and completed suicide. Multicentre study into suicidal behaviour conducted by WHO indicate that the highest average yearly European coefficients of suicide attempts have been detected in young females ranging in age from 15 to 24 years. Polish and foreign literature on the subject is dominated by publications regarding completed suicide. The issue of attempted suicide is treated rather marginally, which may be due to the scantiness of reliable data concerning large populations. The past few years, however, brought a significant advancement of the research into the epidemiology, etiology, and treatment of suicidal behaviour in adolescents. It is difficult to establish linear correspondence between risk factors and suicidal behaviour. The cause is usually a combination of constitutional factors including genetic ones, earlier personal experiences, and precipitating stressful events. Paradoxically, the risk of suicide among adolescents increases in highly developed countries, where the quality of life has undergone a significant improvement. In conclusion, the authors have stressed the importance of an interdisciplinary approach to work with individuals endangered by the risk of suicide. Attention has also been drawn to the importance of personal contact and the necessity to accompany the individual in suicidal crisis from the beginning to the end of the therapy.