AFFECTIVE DISORDER, SUBSTANCE ABUSE, TEEN SUICIDE & HEAL

本研究探讨了重性情感障碍与 以及药物滥用，死亡时的醉酒状态， 在108个连续的样本中， 在伊利诺伊州附近发生的青少年自杀事件 个县我们将使用相同的仪器研究2个对照组， 程序：（a）匹配的青少年生活在同一个街区， 自杀受害者，和（B）作为乘客死于汽车事故青少年。 邻里样本将使我们能够估计基本利率 精神病理学在同一社区的青少年中的自杀 受害者，以便我们可以评估我们的方法和评分员的可行性 参考已发表的流行病学研究，因此我们可以评估 自杀受害者与社区同龄人的对比。的 汽车事故样本假发允许我们应用相同的方法（多个 被调查者，回顾性回忆），以家庭被调查者谁是急性 在突然暴力地失去孩子后痛失亲人我们选择了这些 比较组学习的程度，方法策略 (e.g.,结合线人报告的方法，暴力死亡的影响， 悲伤的报告告密者，时间流逝，因为死亡）混淆一个 青少年自杀的心理剖析 使用结构化 符合DSM-M-R标准的临床访谈和经验丰富的临床 访谈者将使我们能够估计主要疾病的可靠患病率， 情感障碍、物质滥用/依赖和其他主要 精神疾病，所以我们将能够比较我们的研究结果与 来自青少年人群的其他临床研究。标准化 在一个中心实验室进行的毒理学试验将建立 酒精和精神药物的存在，类型和水平 所有自杀者的血液 我们将估计严重情感障碍的患病率， 青少年连续自杀样本中物质滥用/依赖 受害者，青少年车祸受害者，和正常的青少年匹配， 自杀的受害者。我们假设：（a）一年的患病率 对于伴随的情感障碍和物质滥用/依赖， 在自杀样本中的比例高于其他两个样本， 伴随情感障碍和物质的家族史 滥用/依赖在自杀样本中比在 （B）在儿童期内使用酒精和精神活性药物的流行率 自杀样本中死亡前的小时数并不高于 （c）年内的医疗服务使用率 在自杀样本中，死亡前的死亡率高于其他任何一个样本 两个.青少年自杀与精神因素的联系 关于卫生保健利用的信息可能会提供新的见解， 对小学教育即时实用价值

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