Rise in Suffocation Suicides Seen Among Youths in US
June 10, 2004

NEW YORK (Reuters Health) - Over the last decade in the US, the percentage of suicides by children and adolescents involving firearms has dropped markedly, while at the same time suffocation-related suicides -- primarily hanging -- have been on the rise, new research shows.

The good news is that the overall suicide rate in this age group has decreased.

These findings appear in the June 11th issue of the Morbidity and Mortality Weekly Report -- a special edition devoted to suicide trends in the US and elsewhere. Other reports in this edition indicate that suicide among high school students is intimately linked to physical fighting, but that most school-associated suicides do not involve students with a history of fighting or disobedient behavior.

Between 1992 and 2001, the annual suicide rate for people between 10 and 19 years of age fell from 6.2 to 4.6 per 100,000 population, researchers from the Centers for Disease Control and Prevention report.

In 2001, suicide was the third leading cause of death for children and adolescents. The most common suicide method was by firearm (49%), followed by suffocation (38%) and poisoning (7%), the investigators note.

Despite being the most common suicide method, firearms were used less often to commit suicide in 2001 than in 1992. During this period, the rate of firearm suicides declined from 0.9 to 0.4 per 100,000 population. In contrast, at the same time, the rate of suffocation suicides increased from 0.5 to 0.8 per 100,000 population.

In a survey of US high school students in 2001, CDC investigators found that subjects who reported attempting suicide were nearly four times more likely to relate a history of physical fighting than their peers who had not attempted suicide. Overall, 1 in 20 high school students reported both attempting suicide and being involved in fighting.

"Strategies determined effective in reducing youth problem behaviors (e.g., skill and competence-building programs, positive youth development, and parent training) might reduce underlying risks and provide the skills and support students need to avoid fighting and suicidal behavior," the authors point out.

In a study looking at school-associated suicides between 1994 and 1999, suicides accounted for 28 (22%) of the 126 lethal acts of school violence. With the exception of 8 students who intentionally injured someone before their suicide, the majority had no history of fighting or violent behavior. One in four of the suicides were preceded by a romantic break-up and nearly one in five involved drug/alcohol use at the time of suicide.

"Suicide-prevention efforts are needed not only to address the risk for school-associated violence, but also to reduce the much larger problem of self-directed violence among adolescents overall," the researchers state.

Mor Mortal Wkly Rep CDC Surveill Summ 2004;53:471-478.