Suicide in adolescents with no apparent psychopathology.

OBJECTIVE To delineate the characteristics of adolescent suicide victims with no apparent psychiatric disorder. METHOD Seven adolescent suicide victims with no apparent disorder were compared with 60 suicide victims with definite or probable psychiatric disorder, and with 38 community controls with no psychiatric disorder. RESULTS Suicide victims without psychiatric disorder, compared with the remainder of suicides showed lower rates of past psychiatric treatment, previous suicide attempt, family history of affective illness, total life stressors over the previous 12 months, and a greater prevalence of the availability of a loaded gun in the home. The seven suicide victims compared with the 38 psychiatrically normal community controls, showed a higher rate of familial psychiatric disorder, past suicidal ideation or behavior, legal or disciplinary problems in the past year, and firearms in the home, particularly those that were loaded. CONCLUSION Even suicide victims without apparent psychiatric disorder still show some evidence of psychiatric risk factors compared with community controls. However, prevention of suicide in this group is probably best achieved by restriction of the availability of firearms, particularly loaded ones. The clinician should pay particular attention to suicidal risk in youth who are confronting legal or serious disciplinary crises and should take suicidal ideation seriously even in the absence of clear psychopathology.