Citation

Rutz EM. Evid. Based Ment. Health 2008; 11(2): 55.

Affiliation

Karolinska Institutet, Stockholm, Sweden

Copyright

(Copyright © 2008, BMJ Publishing Group)

DOI

10.1136/ebmh.11.2.55

PMID

18441144

Abstract

Comments on: Melhem NM, Brent DA, Ziegler M, et al. Familial pathways to early-onset suicidal behavior: familial and individual antecedents of suicidal behavior. Am J Psychiatry 2007;164:1364–70.

The article by Melhem and colleagues analysed familial and individual risk factors for early onset suicidal behaviour. In accordance with previous studies this prospective study found the risk for youth suicide attempt and emergency referrals for suicidal ideation increased in association with impulsive aggression and mood disorder in the offspring, and sexual abuse, depression and suicide attempt in the parents.

Parental depression and suicide attempt are well known risk factors for offspring suicide attempt, and have only recently been shown to interact strongly with mental disorder in the offspring. Aggregation of suicidal behaviour in families is due to genetic (including transmission of liability to psychiatric disorders as well as aggressive, impulsive traits) as well as non-genetic factors such as imitation, stress of bereavement and physical and sexual abuse. The findings of the present study suggest the importance of a thorough assessment of the suicidal behaviour and mental disorders in the whole family when assessing and treating an adolescent or young adult with mental disorder and suicidal behaviour.

Considering the strength of parental risk factors for early onset suicidal behaviour, early preventative intervention for families at psychosocial risk, in the form of family treatment, is likely to be effective. The findings further suggest that early recognition and treatment of early onset depression and impulsive aggressive behaviour in high-risk youth may help to decrease the incidence of youth suicidal behaviour. It should be noted that screening in schools and in primary care has proven effective in identifying youth at high risk for suicidal behaviour, making such timely intervention possible.

Language: en