David Baxter PhD
Late Founder
Teen suicide spike following black box warnings not an anomaly
Anxiety Insights
Sept. 3, 2008
A sudden and dramatic increase in pediatric suicides may reflect an emerging trend rather than a single-year anomaly. That's the conclusion of new research which looked at pediatric suicide trends over a 10-year period, conducted at The Research Institute at Nationwide Children's Hospital and published in the September 3rd issue of the Journal of the American Medical Association (JAMA).
Following more than a decade of steady decline, the suicide rate among U.S. youth younger than 20 years of age increased by 18 percent from 2003-2004 - the largest single-year change in the pediatric suicide rate over the past 15 years. Although worrisome, the one-year spike observed in 2003-2004 did not necessarily reflect a changing trend. So researchers have been waiting to examine national youth suicide data from 2005 in order to determine whether the increase persisted from 2004-2005, and it don't look promising.
"Suddenly in 2004 we see the sharpest increase in the past 15 years and it appears that it's persisting into 2005," says the study's lead author, Jeff Bridge, PhD, a principal investigator in The Research Institute at Nationwide Children's Hospital.
The researchers estimated the trend in suicide rates from 1996-2003 using log-linear regression. Using that trend line, they estimated the expected suicide rates in 2004 and 2005 and compared the expected number of deaths to the actual observed number of deaths. Researchers found that although the overall observed rate of suicide among 10 to 19 year olds decreased by about 5 percent between 2004 and 2005 (the year following the initial spike) both the 2004 and 2005 rates were still significantly greater than the expected rates, based on the 1996-2003 trend.
"The fact that this significant increase in pediatric suicides continued into 2005 implies that the alarming spike witnessed from 2003-2004 was more than just a single-year anomaly," said Dr Bridge. "We now need to consider the possibility that the increase is an indicator of an emerging public health crisis."
In order to understand the possible causes behind the increase researchers say additional studies must be conducted.
One answer may lie in the prescription of antidepressant medication. Because of concerns over possible increases in suicidal behaviors linked to the drugs, the number of kids prescribed antidepressants has dropped by as much as 20 percent according to John Campo, MD, Chief of Child & Adolescent Psychiatry at Nationwide Children's Hospital, and this may be having a dire impact.
"The vast majority of young people who complete suicide have some sort of psychiatric disorder. Most commonly depression or some mood disorder," Dr Campo.
So the kids who need the medicine most may not be getting it. Campo says there is no proven link between the drop in prescriptions and the rise in suicides, but the fact that they happened at the same time is worth further investigation.
Other factors that should be considered as possible contributors include the influence of internet social networks and increases in suicide among U.S. troops.
Researchers stress that, whatever the explanation, effective interventions to reduce pediatric suicides must be addressed nationally.
Source: Bridge JA, Greenhouse JB, Weldon AH, Campo JV, Kelleher KJ. Suicide Trends Among Youths Aged 10 to 19 Years in the United States, 1996-2005. JAMA. 2008;300(9):1025-1026. [Extract]
Anxiety Insights
Sept. 3, 2008
A sudden and dramatic increase in pediatric suicides may reflect an emerging trend rather than a single-year anomaly. That's the conclusion of new research which looked at pediatric suicide trends over a 10-year period, conducted at The Research Institute at Nationwide Children's Hospital and published in the September 3rd issue of the Journal of the American Medical Association (JAMA).
Following more than a decade of steady decline, the suicide rate among U.S. youth younger than 20 years of age increased by 18 percent from 2003-2004 - the largest single-year change in the pediatric suicide rate over the past 15 years. Although worrisome, the one-year spike observed in 2003-2004 did not necessarily reflect a changing trend. So researchers have been waiting to examine national youth suicide data from 2005 in order to determine whether the increase persisted from 2004-2005, and it don't look promising.
"Suddenly in 2004 we see the sharpest increase in the past 15 years and it appears that it's persisting into 2005," says the study's lead author, Jeff Bridge, PhD, a principal investigator in The Research Institute at Nationwide Children's Hospital.
The researchers estimated the trend in suicide rates from 1996-2003 using log-linear regression. Using that trend line, they estimated the expected suicide rates in 2004 and 2005 and compared the expected number of deaths to the actual observed number of deaths. Researchers found that although the overall observed rate of suicide among 10 to 19 year olds decreased by about 5 percent between 2004 and 2005 (the year following the initial spike) both the 2004 and 2005 rates were still significantly greater than the expected rates, based on the 1996-2003 trend.
"The fact that this significant increase in pediatric suicides continued into 2005 implies that the alarming spike witnessed from 2003-2004 was more than just a single-year anomaly," said Dr Bridge. "We now need to consider the possibility that the increase is an indicator of an emerging public health crisis."
In order to understand the possible causes behind the increase researchers say additional studies must be conducted.
One answer may lie in the prescription of antidepressant medication. Because of concerns over possible increases in suicidal behaviors linked to the drugs, the number of kids prescribed antidepressants has dropped by as much as 20 percent according to John Campo, MD, Chief of Child & Adolescent Psychiatry at Nationwide Children's Hospital, and this may be having a dire impact.
"The vast majority of young people who complete suicide have some sort of psychiatric disorder. Most commonly depression or some mood disorder," Dr Campo.
So the kids who need the medicine most may not be getting it. Campo says there is no proven link between the drop in prescriptions and the rise in suicides, but the fact that they happened at the same time is worth further investigation.
Other factors that should be considered as possible contributors include the influence of internet social networks and increases in suicide among U.S. troops.
Researchers stress that, whatever the explanation, effective interventions to reduce pediatric suicides must be addressed nationally.
Source: Bridge JA, Greenhouse JB, Weldon AH, Campo JV, Kelleher KJ. Suicide Trends Among Youths Aged 10 to 19 Years in the United States, 1996-2005. JAMA. 2008;300(9):1025-1026. [Extract]
