Adolescent and Young Adult Suicide: A 10‐Year Retrospective Review of Kentucky Medical Examiner Cases

ABSTRACT: The compilation of all suicidal causes of death attained the third highest ranking of mortality between the ages of 15 and 24 following unintentional deaths and homicide in the United States, accounting for approximately 4000 deaths in 2002. A variety of biopsychosocial factors may contribute to adolescent suicidal behavior, including psychiatric disorders, risk‐taking behaviors, and lack of a cohesive family unit. The authors conducted a 10‐year (1993–2002) retrospective review of 108 Medical Examiner cases of suicide ages 11–17 and 358 cases ages 18–24 in Kentucky, which represents two thirds of the Coroner cases in the state. The majority of victims were male and Caucasian. The major causes of death were the same for the two age groups, specifically, firearm injury (72.2% and 70.7%), hanging (22.2% and 18.7%), and drug intoxication (2.8% and 5.3%). An integrated Coroner‐Medical Examiner system profits in the public health arena by providing collaborative research data for policy decisions. The prevalence of youth suicide by firearm should prompt further discussion regarding ways to better identify high‐risk adolescents and young adults and restrict pediatric access to unsecured household firearms.

[1]  M. Hufford.  Alcohol and suicidal behavior. , 2001, Clinical psychology review.

[2]  L. Hankoff.  Reducing Suicide: A National Imperative , 2003 .

[3]  T. Ho,et al.  Suicide notes: what do they tell us? , 1998, Acta psychiatrica Scandinavica.

[4]  A. Beautrais.  Suicide and serious suicide attempts in youth: a multiple-group comparison study. , 2003, The American journal of psychiatry.

[5]  L. E. Weinberger,et al.  Psychological factors in the determination of suicide in self-inflicted gunshot head wounds. , 2000, Journal of forensic sciences.

[6]  D. Brent,et al.  Firearms and adolescent suicide. A community case-control study. , 1993, American journal of diseases of children.

[7]  J. Gerberding,et al.  Methods of suicide among persons aged 10-19 years--United States, 1992-2001. , 2004, MMWR. Morbidity and mortality weekly report.

[8]  D. Hemenway,et al.  Household Firearm Ownership and Suicide Rates in the United States , 2002, Epidemiology.

[9]  K. A. Collins,et al.  Suicide under the age of eighteen: a 10-year retrospective study. , 1999, The American journal of forensic medicine and pathology.

[10]  P. Gutierrez,et al.  Testing a model of suicide ideation in college students. , 2005, Suicide & life-threatening behavior.

[11]  D H Mills,et al.  Operational criteria for the determination of suicide. , 1988, Journal of forensic sciences.

[12]  J A Perper,et al.  The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study. , 1992, JAMA.

[13]  D. Brent,et al.  Risk factors for adolescent suicide and suicidal behavior: mental and substance abuse disorders, family environmental factors, and life stress. , 1995, Suicide & life-threatening behavior.

[14]  L. Shields,et al.  Suicide: a ten-year retrospective review of Kentucky medical examiner cases. , 2005, Journal of forensic sciences.

[15]  S. Brandon,et al.  The science of public messages for suicide prevention: a workshop summary. , 2005, Suicide & life-threatening behavior.

[16]  F P Rivara,et al.  Firearm regulations and rates of suicide. A comparison of two metropolitan areas. , 1990, The New England journal of medicine.

[17]  D. Grossman,et al.  Gun storage practices and risk of youth suicide and unintentional firearm injuries. , 2005, JAMA.

[18]  J. M. Conn,et al.  The emergence of youth suicide: an epidemiologic analysis and public health perspective. , 1987, Annual review of public health.

[19]  L. Magder,et al.  Psychotropic practice patterns for youth: a 10-year perspective. , 2003, Archives of pediatrics & adolescent medicine.

[20]  W. McMahon,et al.  Utah youth suicide study, phase I: government agency contact before death. , 2002, Journal of the American Academy of Child and Adolescent Psychiatry.

[21]  E. Shneidman,et al.  Investigations of Equivocal Suicides , 1963 .

[22]  D. Shaffer,et al.  Psychiatric diagnosis in child and adolescent suicide. , 1996, Archives of general psychiatry.

[23]  J. Lönnqvist,et al.  Precipitant stressors in adolescent suicide. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[24]  R. Maris.  The adolescent suicide problem. , 1985, Suicide & life-threatening behavior.

[25]  J. Vernick.  Suicide in the home in relation to gun ownership. , 1992, The New England journal of medicine.

[26]  L. E. Weinberger,et al.  Child and adolescent suicide in a large, urban area: psychological, demographic, and situational factors. , 2001, Journal of forensic sciences.

[27]  D. Brent,et al.  Age- and sex-related risk factors for adolescent suicide. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[28]  J. Lönnqvist,et al.  Psychosocial stressors more common in adolescent suicides with alcohol abuse compared with depressive adolescent suicides. , 1994, Journal of the American Academy of Child and Adolescent Psychiatry.

[29]  J. Lönnqvist,et al.  Adolescent suicide: endpoint of long-term difficulties. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[30]  B. Koplin,et al.  Suicidality in children and adolescents: a review , 2002, Current opinion in pediatrics.

[31]  D. Poteet.  Adolescent Suicide: A Review of 87 Cases of Completed Suicide in Shelby County, Tennessee , 1987, The American journal of forensic medicine and pathology.

[32]  K. A. Collins,et al.  Suicide under the age of eighteen: a 10-year retrospective study , 1999 .

[33]  David N. Miller,et al.  Youth suicide prevention: a survey of public school superintendents' acceptability of school-based programs. , 2005, Suicide & life-threatening behavior.

[34]  D. Shaffer,et al.  Psychosocial risk factors of child and adolescent completed suicide. , 1996, Archives of general psychiatry.

[35]  R. Weisheit,et al.  Changing age patterns of U.S. male and female suicide rates, 1934-1983. , 1988, Suicide & life-threatening behavior.

[36]  D. Brent,et al.  Psychiatric risk factors for adolescent suicide: a case-control study. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[37]  P. Gruenewald,et al.  Suicide rates and alcohol consumption in the United States, 1970-89. , 1995, Addiction.

[38]  W. Marine,et al.  Adolescent suicide and household access to firearms in Colorado: results of a case-control study. , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[39]  D. Hemenway,et al.  Youth suicide: insights from 5 years of Arizona Child Fatality Review Team data. , 2004, Suicide & life-threatening behavior.

[40]  B. Burr,et al.  Epidemiology, risk factors, intervention, and prevention of adolescent suicide. , 1998, Current opinion in pediatrics.

[41]  D. Shaffer,et al.  Preventing teenage suicide: a critical review. , 1988, Journal of the American Academy of Child and Adolescent Psychiatry.

[42]  Laura Kann,et al.  Youth risk behavior surveillance--United States, 2003. , 2004, Morbidity and mortality weekly report. Surveillance summaries.

[43]  T. Hampton.  Suicide caution stamped on antidepressants. , 2004, JAMA.