Suicide in adolescents: findings from the Swiss National cohort

For The Swiss National Cohort ,Nicole Steck,Matthias Egger,Stephan Kupferschmid,Benno G Schimmelmann

doi:10.1007/s00787-017-1019-6

Abstract

Suicide in adolescents is the second most common cause of death in this age group and an important public health problem. We examined sociodemographic factors associated with suicide in Swiss adolescents and analysed time trends in youth suicide in the Swiss National Cohort (SNC). The SNC is a longitudinal study of the whole Swiss resident population, based on linkage of census and mortality records. We identified suicides in adolescents aged 10–18 years from 1991 to 2013. A total of 2.396 million adolescents were included and 592 suicides were recorded, corresponding to a rate of 3.7 per 100,000 [95% confidence interval (CI) 3.4–4.0]. Rates increased with age from 0.0 per 100,000 at age 10 years to 14.8 per 100,000 (95% CI 12.6–17.5) at 18 years in boys, and from 0.0 to 5.4 per 100,000 (4.1–7.2) in girls. Being a boy, living in a single parent household, being an only or middle-born child, and living in rural regions were factors associated with a higher rate of suicide. Hanging was the most common method in boys, and railway suicides were most frequent in girls. There was no clear evidence for an increase or decrease over calendar time. We conclude that familial and socioeconomic factors including type of household, birth order and urbanity are associated with youth suicide in Switzerland. These factors should be considered when designing prevention programmes for youth suicide.

Highlights

Recognised as an important public health problem by the World Health Organization (WHO) [1], suicide in youth is a rare but tragic event, with severe implications for the families and friends concerned
Adolescent girls experience a higher rate of suicidal ideation and suicide attempts [6, 8], but boys are more likely to complete suicide than girls [3, 6, 8] mirroring the situation in adults
Whereas conflicts with parents and maltreatment are often reported in suicides of younger adolescents, crises in romantic relationships and psychological disorders are more important in older adolescents [16,17,18]

Summary

Introduction

Recognised as an important public health problem by the World Health Organization (WHO) [1], suicide in youth is a rare but tragic event, with severe implications for the families and friends concerned. We analysed a large national cohort study to examine suicide rates in youth, the chosen methods of suicide and reported psychiatric conditions. The Swiss National Cohort (SNC) is a longitudinal study of mortality in Switzerland based on linkage of census and mortality records. Type of household (single person with children, couple with children, institution), birth order (only child, firstborn, middle born or lastborn), highest education of parents (compulsory schooling, secondary, tertiary education), age of mother at birth (in 10-year bands), religion (Protestant, Catholic and no affiliation) and nationality of the adolescent (Swiss or foreign), degree of urbanization of place of residence (urban, periurban and rural), socioeconomic position of neighbourhood of residence (quartiles of the Swiss index [27]) and language region (German, French and Italian). Depressive disorders were most frequently reported (74 suicides), followed by alcohol and drug use (13 suicides) and schizophrenia (nine suicides)

Results

Discussion

Compliance with ethical standards