Suicide 'Contagion' Seen in Teens

When a casual acquaintance or classmate commits suicide, it can serve as a flash point to increase both suicide ideation and suicide attempts within peer groups.

In cross-sectional analysis of data from a national longitudinal survey, exposure to a peer's suicide was associated with suicide ideation in 15% of respondents ages 12 to 13 versus a rate of 3.4% among same-age teens who were not exposed, Ian Colman, PhD, of the University of Ottawa in Ontario and Sonja A. Swanson, ScM, of the Harvard School of Public Health reported in CMAJ.

Among 14- to 15-year-olds, 14% reported thinking about suicide after learning of a friend or classmate's suicide and the rate was was 15% among those ages 16 to 17. Among teens with no exposure to suicide 5% of those ages 14 to 15 and 7.4% of the older teens reported thinking about suicide.

"Adolescents may be particularly susceptible to this contagion effect," Colman and Swanson wrote. "More than 13% of adolescent suicides are potentially explained by clustering [which] may explain an even larger proportion of suicide attempts."

Exposure to suicide was also associated with an increased rate of suicide attempts -- 7.5% among the youngest group, 8.6% for those 14 to 15 years old, and 8% in the oldest group, versus 2%, 2.3%, and 3%, respectively, among teens with no exposure to suicide.

The authors found that while knowledge of suicide increased risk, the risk was not greater if the suicide victim was a close friend.

The likelihood of exposure to suicide increased with age so that by the time they were 16- to 17-years-old, 24% of respondents said they were exposed to a classmate's suicide, and 20% reported knowing the child personally.

"The idea that suicide is contagious has always been controversial for various reasons. However, this important study should put many, if not all, doubts to rest," wrote India Bohanna, PhD, of James Cook University, Cairns, Queensland, Australia in an accompanying commentary. "We need to know what works in mitigating the risk of contagion and why. Only then can such strategies be confidently used to help those most vulnerable to the after effects of suicide: our youth."

The analysis was based on responses from 22,064 adolescents included in the National Longitudinal Survey of Children and Youth study.

The authors also assessed 2-year outcomes among respondents between age 12 and 15: A suicide by a classmate predicted suicide attempts among respondents age 12 to 13 (OR 3.07, 95% CI 1.05-8.96) and 14 to 15 (OR 2.72, 95% CI 1.47-5.04).

The authors stated that limitations included unmeasured confounding, degree of proximity, and lack of information about post suicide intervention programs or media after a suicide.

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