AFFECTIVE DISORDER, SUBSTANCE ABUSE, TEEN SUICIDE & HEAL

这项研究调查了严重的情感障碍与 和药物滥用，死亡时的醉酒状态， 和卫生保健利用模式在108个连续的样本中 发生在伊利诺伊州的青少年完全自杀事件 各县。我们将使用相同的工具研究两个对照组，并 程序：(A)居住在同一社区的匹配青少年 自杀受害者，以及(B)因乘客车祸而死亡的青少年。 邻里样本将使我们能够估计基本利率 自杀所在社区青少年的精神病理学 受害者，这样我们就可以评估我们的方法和评分器的可信程度 参考已发表的流行病学研究，因此我们可以评估 以自杀受害者为背景的社区同龄人。这个 车祸样本假发允许我们应用相同的方法(多个 告密者，追溯召回)向敏锐的家庭告密者 在突然而猛烈地失去一个孩子之后失去了亲人。我们选择了这些 比较组了解方法论策略的程度 (例如，综合举报人报告的方法、暴力死亡的影响和 对举报人报告的悲痛，死亡后的时间流逝)迷惑了 青少年自杀的心理尸检。结构化的用法 符合DSM-M-R标准的临床访谈和经验临床 面试者将使我们能够估计主要疾病的可靠患病率 情感障碍、药物滥用/依赖和其他主要疾病 精神障碍，所以我们将能够将我们的发现与 那些来自青少年人群的其他临床研究。标准化 在一个集中实验室进行的毒理学分析将确定 酒精和精神活性药物的存在、类型和水平 所有自杀受害者死亡时的血液。 我们将估计严重情感障碍的患病率和 连续青少年自杀样本中的药物滥用/依赖 受害者，青少年车祸受害者和正常青少年匹配 自杀受害者。我们假设：(A)一年的患病率 对于伴随的情感障碍和药物滥用/依赖是 在自杀样本中比其他两个样本中的任何一个都要高，并且 伴发情感性精神障碍的家族史和实质 虐待/依赖在自杀样本中比在任何一种情况下更常见 其他两个；(B)年内酗酒和使用精神药物的情况 在自杀样本中，死亡前的几个小时并不比 车祸样本；及(C)年内医疗服务使用率 自杀样本中死亡前的比例高于其他任何一个 二。青少年自杀与精神因素的关联 关于医疗保健利用的信息可能会提供新的见解 对小学的直接实用价值

This study investigates the relationship between major affective disorder and substance abuse, the presence of intoxicated states at time of death, and health care utilization patterns in a sample of 108 consecutive completed adolescent suicides occurring in from contiguous Illinois counties. We will study 2 comparison groups using the same instruments and procedures: (a) matched adolescents living in the same neighborhood as the suicide victim, and (b) adolescents who die as passengers auto accidents. The Neighborhood Sample will allow us to estimate base rates of psychopathology among adolescents in the same communities as the suicide victim so that we can evaluate the plausibility of our method and raters with reference to published epidemiological studies, and so we can assess the suicide victims against the background of community-based peers. The Car Accident Sample wig allow us to apply the same method (multiple informants, retrospective recall) to family informants who are acutely bereaved after the sudden and violent loss of a child. We have chosen these comparison groups to learn the degree to which methodological strategies (e.g., method of combining informant reports, impact of violent death & grief on the report of informants, lapse of time since death) confound a psychological autopsy of adolescent suicide. The use of structured clinical interviews with DSM-M-R criteria & experienced clinical interviewers will enable us to estimate sturdy prevalence rates of major affective disorders, substance abuse/dependence, and other major psychiatric disorders, so we will be able to compare our findings with those from other clinical studies of adolescent populations. Standardized toxicology assays performed in one centralized laboratory will establish the presence, types, and levels of alcohol and psychoactive drugs in the blood of all suicide victims at death. We will estimate the prevalence rates for major affective disorder and substance abuse/dependence in a sample of consecutive adolescent suicide victims, adolescent car accident victims, and normal adolescents matched to the suicide victims. We hypothesize that: (a) the one-year prevalence rates for concomitant affective disorder and substance abuse/dependence are higher in the Suicide Sample than in either of the other two, and that a family history of concomitant affective disorder and substance abuse/dependence is more common in the Suicide Sample than in either of the other two; (b) the prevalence of alcohol and psychoactive drug use during the hours preceding death is not higher in the Suicide Sample than in the Car Accident Sample; and (c) health care utilization rates during the year prior to death are higher in the Suicide Sample than in either of the other two. The linking of psychiatric factors implicated in adolescent suicide with information about health care utilization may offer new insights of immediate practical value to primary