Suicide in childhood and adolescence Retrospective 20-year analysis of autopsies from the Institute of Legal Medicine Leipzig

Background: In western Europe, suicide is the second or third most common cause of death among children and adolescents after traffic accidents and is an extreme burden for the bereaved.Method: In an anonymous retrospective data analysis non-natural cases of death among children and adolescents reported in the coverage area of the Institute of Legal Medicine Leipzig, Saxony during the period 1998-2017 were examined.The prevalence of suicides was analyzed regarding gender and suicide methods as well as the correlation to substance and alcohol abuse and signs and existing evidence of mental health disorders.Results: The suicides among adolescents concerned significantly more males (p < 0.05) than females. None were younger than 12 years old. The most frequent suicide method was railway suicide (27%) followed by jumping from a height (22%), intoxication (21%) and hanging (12%). A significant connection between the suicide of children as well as adolescents and positive toxicological findings (chi(2) = 27.16; p < 0.001) was found and signs of psychiatric illnesses could be shown.Conclusion: Substance abuse and signs of mental health disorders or psychiatric disorders are associated with suicide among children and adolescents. Mental health disorders play a key role, as they can significantly increase the suicide risk. Early identification of mental health disorders for teenagers, e.g. via observation of attitude change, self-injury or sudden substance use, can play a major part in the prevention of suicide.