Suicide and sudden violent death among young people: Two sides of the same coin?

Abstract

The aim of the present study was to compare risk factors for death by suicide and sudden violent death (SVD) among young people aged 10-25 years. Two target samples, 63 consecutive cases of youth suicide and 62 cases of SVD, were compared on potential risk factors differentiating the two groups from 104 controls. Data on psychiatric diagnoses, psychosocial factors, adverse childhood experiences, stressful life events, and coping strategies were collected in psychological autopsy interviews. Distinguishing for the suicide group was lower frequency of living in a steady relationship, adult psychiatric care, depression, autism spectrum disorder, being sexually assaulted, higher frequency of recent stressful life events, and lowest levels of adaptive coping. Distinguishing for the SVD group was a predominance of males, lower elementary school results, abuse of psychoactive drugs, being investigated or sentenced for criminal acts, conduct disorder or antisocial personality disorder. Common risk factors for both kinds of premature unnatural death included lower educational level, absence of work or studies, different forms of addiction, child and adolescent psychiatric care, borderline personality disorder, adverse childhood experiences, and less adaptive coping. Accordingly, there is a common ground of vulnerabilities, early adversities, and recent strains in life for both forms of premature death, but also substantial differences between these contrasting lethal developments. Prevention of both suicide and SVD should focus on adverse childhood experiences, learning difficulties, meaningful occupation, more adaptive coping, addiction, and treatment of borderline personality disorder. Suicide prevention should comprise promotion of adaptive stress management skills, depression prevention and treatment, and paying attention to young people with autism. SVD prevention should involve early response to learning difficulties, abuse of psychoactive drugs and delinquent behavior, and treatment of conduct disorder and antisocial personality disorder.