Adolescent suicide attempts and melancholia.
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Biomedical subjects
Publications and source records attributed to F E Crumley.
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Although suicide among adolescents has been increasing over the past decade, there are surprisingly few clinical studies regarding teen-agers who have attempted suicide. A previous study showed borderline personality disorder as the most common underlying personality problem among a group of predominantly hospitalized adolescents. This paper focuses on the clinical characteristics of 22 teen-agers with a borderline personality disorder who had attempted suicide. The essential pattern of a borderline personality was a persistent instability in a variety of areas, including interpersonal relations, mood, behavior, and self-image. The most prominent characteristics associated with suicide attempts by these adolescents were a tendency to react severely to loss, poorly controlled anger, and self-defeating impulsivity. Many of the characteristic behavioral symptoms of these borderline patients must be determined by a longitudinal history of the teen-ager's life. Specific treatment approaches are needed for these patients.
The conditions of 40 adolescents in treatment following a suicide attempt were diagnosed according to the multiaxial classification of the American Psychiatric Association's proposed third edition of the diagnostic and statistical manual. All were psychiatrically ill before the suicide attempt. The most common diagnoses were those of depressive disorders and substance abuse disorders on the clinical psychiatric syndrome axis and borderline personality disorder on the personality and developmental disorder axis. The typical patient was a polydrug-abusing girl with a borderline personality disorder and a superimposed major depressive disorder. The most prominent personality characteristics associated with suicide attempts by these adolescents were a tendency to react severely to a loss, poorly controlled rage, and impulsivity. Suicide attempts by adolescents should be taken seriously by the physician and necessitate a thorough search for a possible underlying pathological condition.
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