Jan. 11, 2000 (New York) -- A study conducted by the CDC found that one in ten college students admitted to having suicidal thoughts during the 12 months preceding the survey. Doctors who interface with college-aged adolescents should be alert to cues such as substance abuse that may alert them to suicide risk, according to a study published in the Journal of Consulting and Clinical Psychology.
"The field has gotten a big push recently from the surgeon general in his call to action that suicide is a major problem, especially among young people ... It's the third leading cause of death of people aged 15 to 24", lead author Nancy D. Brener, PhD, of the CDC, tells WebMD. "Given that we know from our study that those who use tobacco, alcohol, or illegal drugs are at increased risk of having considered suicide, it's a potential place for clinicians to intervene."
The data was collected in 1995 as part of the National College Health Risk Behavior Survey that produced a nationally representative sample of undergraduate college students aged 18 or older in two- and four-year U.S. public and private colleges and universities. Almost 5,000 students completed the 96-item questionnaire. Students were asked about suicidal thoughts and actions in the preceding 12 months and whether they used tobacco, alcohol, or illegal drugs.
Ten percent of the students admitted to seriously considering attempting suicide during the 12 months preceding the survey. Seven percent said they had made a suicide plan, 2% had attempted suicide at least once, and 0.4% had made a suicide attempt that required medical attention.
The investigators found that students who considered suicide in the 12 months prior to the survey were significantly more likely to engage in such risk behaviors as cigarette smoking, episodic heavy drinking, marijuana, cocaine, or other illegal drug use, or combinations of such behaviors. For instance, the odds of engaging in illegal drug use doubled among students who had considered suicide than among those who had not.
"This study is cross-sectional, so we can't conclude about any kind of causation. Given that it's possible that if substance abuse leads to suicidal ideation, if a family practitioner could intervene with the substance use, then it might not progress to become a situation of suicide ideation," says Brener.
Increased suicide risk was noted in some ethnic groups, such as Asians, Pacific Islanders, American Indians, or Alaskan natives. Students who lived with a spouse or domestic partner were less likely to consider suicide than those who lived alone, with roommates or friends, or with parents or guardians. Fraternity and sorority members were also less likely to think about suicide. Suicidal ideation did not vary by gender or parents' education. "[T]hese findings offer some support for previous research showing that social support is often an important protective factor against suicidal behavior," writes Brener.
"Our take-home message is that colleges and universities should establish suicide prevention programs that address the related problems of substance use or improve upon existing programs. The CDC recommends that programs should rely on multiple prevention strategies because we don't know what actually works in terms of suicide prevention," Brener tells WebMD.
Keith King, PhD, a researcher in adolescent suicide prevention at the University of Cincinnati, sees physicians as part of a triangle of resources to identify and prevent adolescent suicide, including the community, family and friends, and the school. In an interview seeking objective commentary, King tells WebMD that "It is imperative that physicians know the warning signs and risk factors of suicide. Warning signs include talking about suicide, giving things away, being depressed or lethargic, losing interest in once-pleasurable activities, and becoming isolated. Risk factors include substance use, being female, easy access to handguns, and feeling lonely and disconnected."
In his experience, Keith has found that while a professional may know the risk factors of suicide, identifying a child at risk often proves to be difficult. "The reality is that there are many of these adolescents who visit a physician who could be helped if the physician knew the warning signs of suicide and follows-up on them."
- Suicide is the third-leading cause of death among 15- to 24-year-olds, and a survey of college students shows that 10% admit to seriously considering suicide.
- Those who consider suicide are significantly more likely to engage in risk behaviors, such as cigarette smoking; episodic heavy drinking; marijuana, cocaine, or other illegal drug use; or a combination of such behaviors.
- Students who live with a spouse or domestic partner, or who belong to a sorority or fraternity, are less likely to think about suicide.