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Suicidal behaviors in depressed adolescents: role of perceived relationships in the family

Angèle Consoli167, Hugo Peyre167, Mario Speranza367, Christine Hassler67, Bruno Falissard567, Evelyne Touchette8, David Cohen19, Marie-Rose Moro467 and Anne Révah-Lévy267*

Author Affiliations

1 Department of Child and Adolescent Psychiatry, GH Pitié-Salpêtrière, APHP, Paris, F-75013, France

2 Centre de Soins Psychothérapeutiques de Transition pour Adolescents, Hôpital d’Argenteuil, Argenteuil, Argenteuil, France

3 Department of Child and Adolescent Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France

4 Maison de Solenn, Hôpital Cochin, APHP, Paris, F-75014, France

5 Département de Santé Publique, Hôpital Paul Brousse, APHP, Villejuif, F-94804, France

6 INSERM U-669, PSIGIAM, Paris, F-75679, France

7 Univ. Paris-Sud, Univ. Paris-Descartes, Paris, F-75005, France

8 Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montreal, Canada

9 CNRS UMR 7222, Institut des Systèmes Intelligents et Robotiques, University Pierre et Marie Curie, Paris, France

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Child and Adolescent Psychiatry and Mental Health 2013, 7:8  doi:10.1186/1753-2000-7-8

Published: 16 March 2013

Abstract

Context

Suicide is the second leading cause of death in adolescents and young adults in Europe. Reducing suicides is therefore a key public health target. Previous studies have shown associations between suicidal behaviors, depression and family factors.

Objective

To assess the role of family factors in depression and suicidality in a large community-based sample of adolescents and to explore specific contributions (e.g. mother vs. father; conflict vs. no conflict; separation vs. no separation) taking into account other risk factors.

Methods

A cross-sectional sample of adolescents aged 17 years was recruited in 2008. 36,757 French adolescents (18,593 girls and 18,164 boys) completed a questionnaire including socio-demographic characteristics, drug use, family variables, suicidal ideations and attempts. Current depression was assessed with the Adolescent Depression Rating Scale (ADRS). Adolescents were divided into 4 groups according to suicide risk severity (grade 1 = depressed without suicidal ideation and without suicide attempts, grade 2 = depressed with suicidal ideations and grade 3 = depressed with suicide attempts; grade 0 = control group). Multivariate regressions were applied to assess the Odds Ratio of potential risk factors comparing grade 1, 2 or 3 risk with grade 0.

Results

7.5% of adolescents (10.4% among girls vs. 4.5% among boys) had ADRS scores compatible with depression; 16.2% reported suicidal ideations in the past 12 months and 8.2% reported lifetime suicide attempts. Repeating a year in school was significantly associated to severity grade of suicide risk (1 and 3), as well as all substance use, tobacco use (severity grades 2 and 3) and marijuana use (severity grade 3), for girls and boys. After adjustment, negative relationships with either or both parents, and parents living together but with a negative relationship were significantly associated with suicide risk and/or depression in both genders (all risk grades), and Odds Ratios increased according to risk severity grade.

Conclusion

Family discord and negative relationship with parents were associated with an increased suicide risk in depressed adolescents. So it appears essential to take intrafamilial relationships into account in depressed adolescents to prevent suicidal behaviours.

Keywords:
Suicide; Depression; Adolescent; Community survey