This study aimed at investigating the relationship between adolescent parasuicide, depressive illness and associated risk factors. Reports worldwide indicate that suicidal behaviour in this age group has risen 150% over the past 20 years, whilst the rate for suicide in adults and the elderly has remained the same (Deykin et al, 1985; Neiger & Hopkins, 1988; Sudak, Ford & Rushforth, 1984a). In South Africa statistics confirm similar trends with regard to attempted and completed suicide. Statistics reveal that a high local incidence of adolescent suicide attempters are seen at psychiatric units. One pilot study recorded 187 adolescent suicide attempters during a three month period. This study was based on the hypothesis that the incidence of depressive illness in adolescent suicide attempters is higher than is generally accepted and that this condition often goes unrecognised and is misdiagnosed because it manifests differently with acting out behaviour and "masked" symptomatology. A random sample of suicide attempters between the ages of 13 - 25 who presented at C23 (psychiatric emergencies) Groote Schuur Hospital following a suicide attempt were assessed. 100 subjects were seen over a period of three months. The research procedure comprised a comprehensive assessment incorporating a semi-structured interview, self-report and objective rating scales for depression as well as instruments designed to assess the general health of each subject and their level of suicide intent. The depressive inventories used have been validated for use in this age group and were designed to elicit the associated features of adolescent depression. If warranted, a clinical diagnoses was given based on DSM 1V criteria. This diagnosis was substantiated by information from the research instruments which formed part of the assessment process. A high incidence of clinical disorders was diagnosed in the sample (86%). Depressive illness was found to be a significant risk factor for suicidal behaviour with 68% of the subjects suffering from an affective disorder and 21% reporting depressive symptoms. This study shows that the correlation between parasuicide and depressive illness is high enough to suggest that all suicidal behaviour in this age group should be taken seriously as parasuicide in itself is often a reliable indicator of an underlying depressive condition. Additional risk factors for adolescent parasuicide identified in this study correlated well with the findings of similar research studies. Psychiatric co-morbidity, especially substance use (42%) and cluster B personality factors (54%), were high and served to increase an individual's vulnerability to suicide risk. Psychosocial factors such as sexual abuse (28%) and physical abuse (37%) were also identified as high risk factors for adolescent suicidal behaviour. Individuals at risk for depression and suicidal behaviour typically came from broken homes which were disrupted and unsupportive. Family members were frequently abusing alcohol and 67% of the subjects reported the presence of psychiatric illness in the family. The preferred method of suicide attempt was an overdose (90%). These attempts were generally unplanned and impulsive with no disclosure prior to the event. Intent was usually high at the time of the act. It is only through identifying the risk factors specific to the developmental concerns of this age group and acknowledging the role of depressive illness in adolescent suicidal behaviour that effective preventative measures can be devised.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:rhodes/vital:3116 |
| Date | January 1996 |
| Creators | Read, Gary Frank Hoyland |
| Publisher | Rhodes University, Faculty of Humanities, Psychology |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis, Masters, MA |
| Format | 108 pages, pdf |
| Rights | Read, Gary Frank Hoyland |
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