Diagnosis and treatment of suicide risk among young people should address all disorders and not just focus on depression, say experts.

Researchers from the World Health Organization (WHO) and the Christchurch School of Medicine in New Zealand examined which mental disorders or combinations of disorders might be most responsible for youth suicide.

They reviewed English-language studies from 1982 to 2001 to re-examine the occurrence and distribution of mental disorders in 894 cases of completed suicides among young people worldwide. Their findings appear in the American Journal of Orthopsychiatry, a publication of the American Psychological Association (APA).

Mood, Substance, Disruptive Disorders

The majority of the cases (89 percent) had at least one diagnosis of a mental disorder. Mood disorders were the most frequent (42 percent) followed by substance-related disorders (40 percent) and then disruptive disorders (20 percent).

Mood disorders include major and minor depressive disorder, dysthymia, mania, hypomania, bipolar disorder and non-specific mood disorders. Substance-related disorders include drug abuse and alcohol dependency/abuse. Disruptive disorders include conduct disorder, attention deficit disorder, oppositional disorder and identity disorder.

Seventy-two percent of the subjects were under 20 years of age. Twelve percent were between the ages of 20 to 29. The remaining 15.5 percent were in the 15-29 year age range.

Studies that met the criteria for this review originated mostly from Europe and North America. Hence, caution is necessary in application of findings from that region to program development in Asian, African, South American or developing countries, the authors note.

Other Contributors

Lead author Alexandra Fleischmann, PhD, and co-authors suggest that comprehensive suicide prevention strategies for young people should target mental disorders as a whole rather than depression alone.

Even though mood disorders were tied to suicide the most, they were identified in fewer cases than expected, they note.

Beyond diagnosable mental disorders, other components -- such as a person's predisposition, social and environmental conditions, psychosocial risk factors and culture -- should be considered in the effort to guard against youth suicide, the authors recommend.