Suicide in children and young adolescents: A 25-year database on suicides from Northern Finland

• Only a minority of the suicide victims had a previous history of psychiatric hospitalization.
• Previous suicidality was more common among female than male adolescents.
• Half of the adolescents were under the influence of alcohol at the time of suicide.
• Alcohol intoxication was related to suicides committed during the night.
• Violent suicide methods were employed in the vast majority of adolescent suicides.

Despite the large amount of research on adolescent suicidality, there are few detailed studies illustrating the characteristics of child and adolescent completed suicide. Our study presents the characteristics of child and adolescent suicides occurring over a period of 25 years within a large geographical area in Northern Finland, with a special focus on gender differences. The study sample included all 58 suicides among children and adolescents (<18 years) occurring in the province of Oulu in Finland between 1988 and 2012. The data is based on documents pertaining to establish the cause of death from forensic autopsy investigations. A register linkage to the data from the Finnish Hospital Discharge Register (FHDR) was also made. 79% of the suicide victims were male. Violent suicide methods predominated in both genders (males 98%, females 83%). While symptoms of mental illness were common, only a minority (15% of males and 17% of females) had a previous history of psychiatric hospitalization. 17% of females but none of the males had been hospitalized previously due to self-poisoning. A greater proportion of females than males had a history of self-cutting (33% vs. 7%) and previous suicide attempts (25% vs. 4%). 48% of males and 58% of females were under the influence of alcohol at the time of their suicide, and alcohol intoxication was related to suicides during the night. One fifth of the adolescents screened positive for substances other than alcohol. The results of this study indicate that there are similarities but also some differences in the characteristics of male and female suicides in adolescents.