Prevalence of suicide among children and adolescents around the world

The data on the frequency of suicides among children and adolescents available in the world literature are sparse and, as a rule, contradictory. The table shows that the highest level of suicides in this age group, amounting to 50-60 cases per 100,000 male adolescents and 30-40 cases per 100,000 female adolescents, was registered in the 1950s and 1960s in Japan and Taiwan. These figures were dozens of times higher than those in the USA, where child and adolescent suicides were registered very rarely in those years (0.4-1.2 cases). Subsequently, this difference became less pronounced due to a decrease in the prevalence of suicides in Japan to 25 and an increase in their level in the USA to 13-14 per 100,000 adolescents, while the prevalence of suicides among black American adolescents was significantly lower than among white ones.

Prevalence of completed suicides in children and adolescents in different countries of the world

Country	Years of research	Age of suicides, years	Rate per 100,000 persons of this age
Japan	1955-1958	12-24	53.8-60.2 (m)
			36.4-39.3 (f)
	1962-1981	15-24	25.0 (average)
	1955-1975	10-14	0.4-1.2
	1961		3.4
	1968	15-19	7.8
USA	1977		14.2
	1978	0-15	0.8
		15-19	7.6
	1980	15-24	13.3
	1984	15-19	9.0
Czechoslovakia	1961		13.0 (m)
	1969	15-19	(and) (m)
			15.0 (f)
Taiwan	1962-1964	12-24	47.8-52.2 (m)
			32.2-37.9 (f)
Germany	1970	15-24	10.1
England	1979-1982	15-24	2.6 (students)
	1996	10-19	8.8 (non-students)
USSR (Kazakhstan)	1984	Up to 20	4.4
	1986		3.1
Russia (Kemerovo region)	1980	10-14	0.8
	1994	10-14	4.6
1994	15-19	49.9
Russia (Tomsk)	1996-1998	15-24	35.2 (average)

In European countries, the prevalence of suicides among children and adolescents (per 100,000 population of this age group) varied in the range from 2-8 cases in England to 13-36 in the former Czechoslovakia. In recent decades, the world has come to believe that adolescence, along with old age, is the most suicidal age.

Analysis of the dynamics of suicide prevalence shows that in most countries of the world there is a clear tendency for their frequency to increase in all age categories of the population, especially rapidly among young people. For example, in the USA, suicide as a cause of death in the general population ranks 11th in frequency, and among young people (15-24 years old) - 3rd, following accidents and murders. Among American students, suicide as a cause of general mortality has reached 2nd place after injuries.

According to P. S. Holinger (1978), in the USA during the period 1961-1975 the frequency of murders of young people doubled, and suicides tripled. In addition, during these same years the prevalence of suicides in adolescence increased by 2.2 times. An even more pronounced increase in the prevalence of suicides in the USA among young people took place in the 1990s: among boys aged 15-19 the frequency of suicides increased by 4 times, and among girls of the same age - by 3 times, while the average indicators of completed suicides in other age categories of the population remained stable.

M.G.Me Clure (1984), based on a statistical analysis of suicides in England and Wales, also came to the conclusion that their frequency has increased among teenagers, while suicides among children under 14 years of age were registered relatively rarely. At the same time, C.R. Pfeffer (1981) cited statistical data confirming the emerging trend in the USA towards an increase in cases of suicidal behavior among children aged 6-12 years. The frequency of child suicides in France has doubled over the past decade, although these cases are still considered "exceptional" in the country. Note that, according to A.A. Lopatin (1995), in the Kemerovo Region of Russia the level of suicides among children increased almost 6 times over the period 1980-1994.

There is also information of the opposite nature. Thus, D. Shaffer and P. Fischer (1981) noted that suicides in children and adolescents are rare compared to adults, and their frequency changes little over time. According to their observations, in 1978 in the USA, suicides accounted for 2.4 and 8% of all causes of death among children and adolescents, respectively. Of all suicides committed in the country during the analyzed year, child and adolescent suicides accounted for only 0.6 and 6.2%, respectively. Based on the data presented, the authors came to the conclusion about the low and relatively stable frequency of suicides among children and adolescents.

It should be noted that most researchers do not share this point of view. Moreover, GL Klerman (1987) points to the frightening epidemic nature of the prevalence of adolescent suicides in recent decades. In his opinion, the increase in the prevalence of depression, alcoholism and drug addiction among people born after World War II during the so-called baby boom was a prerequisite for the subsequent increase in the frequency of suicides and suicide attempts. There is also an opinion according to which suicides, murders and accidents in children and adolescents should be taken into account together, because they are three sides of the so-called epidemic of self-destruction.

The prevalence of attempted suicides in children and adolescents, compared with completed suicides, is largely unstudied because official statistics agencies worldwide do not collect such data. The frequency of attempted suicides can often be estimated only from indirect data, but differences in the methods of collecting them in different countries make it difficult to evaluate the results of such studies.

The only indisputable fact is that in adolescence the number of suicide attempts is several times higher than the number of completed suicides. This pattern is found in most countries where the relevant studies have been conducted. Thus, in European countries among adolescents there are on average 8-10 suicide attempts for every completed suicide. An even greater difference in the frequency between completed suicides and suicide attempts is indicated by H. Hendin (1985), according to whom in the USA the frequency of suicide attempts and completed suicides is determined by the ratio of 100:1. According to A.G. Ambrumova and E.M. Vrono (1983), as well as H. Jacobziener (1985), no more than 1% of suicide attempts among children and adolescents end in death.

A study of literature data on the dynamics of prevalence of suicide attempts in children and adolescents has shown that in recent decades there has been a significant increase in their frequency in different countries of the world. Thus, according to FECrumley (1982), in the USA during the period from 1968 to 1976 the number of persons aged 15-19 who committed suicide attempts doubled and reached 5000 cases per year. In the 90s of the 20th century, children and adolescents began to commit 1 to 2 million suicide attempts per year in the country, in addition, during the same period of time about 12,000 children and adolescents were hospitalized due to suicide attempts.

M. Shafii et al. (1985) cite data showing that over an 8-year period the number of children and adolescents with suicidal behavior who were under observation by the child psychiatric service in Louisville increased by 6.3 times and accounted for 20% of all visits to this service. BD Garfinkel et al. (1982), having examined all children and adolescents who were admitted to the primary care center of one of the US children's hospitals due to attempted suicide, found that such cases accounted for an average of 0.3% of all admissions per year.

In France, 0.4% of adolescents attempt suicide. In Poland, G. Swiatecka and J. Niznikiwicz (1980) found that the number of children and adolescents aged 12-20 admitted to a psychiatric hospital due to suicide attempts increased fourfold over 20 years (1958-1978). One of the large psychiatric hospitals in Czechoslovakia also found an increase in the number of minors who attempted suicide; the number of those hospitalized for this reason amounted to 23.2% of the total number of admissions.

H. Haefner (1983) explains the sharp shifts in the frequency of suicide attempts by changes in the culture of ethnic groups over the years. The most significant fluctuations are observed in age groups most sensitive to changes in the social environment, i.e. among teenagers and young men.

Thus, the analysis of foreign literature data on the prevalence of suicidal behavior among children and adolescents revealed an extremely wide range of their frequency indicators. This indicates differences in the methods of registration and statistical processing of relevant information in different countries and even within one country. The lack of complete information and differences in the methodological principles of research (for example, the incomparability of age groups, the lack of a clear gradation of adolescence, childhood and youth) make it difficult to study the data.

In our country, there have been virtually no studies of the prevalence of suicides among children and adolescents. Only a few works can be cited, in particular the study by A.G. Ambrumova (1984), in which she came to the conclusion that in the USSR the share of adolescent suicides, compared to that of adults, is small, but has a tendency to increase. Thus, in 1983, the share of young people under 20 years old accounted for 3.2%, and in 1987 - already 4% of all suicides committed.

In conclusion, we can conclude that the prevalence of suicides and suicide attempts among children and adolescents is growing in most countries of the world. Particularly alarming is the tendency for the growth rate of these indicators to increase.

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