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Researchers from the UK have undertaken the first long term examination of possible factors leading to suicide attempts in young people considered to be at high risk of suicide.

The researchers from the University of Bristol studied data from the Children of the 90s study. They focused on 310 teenagers aged 16 who had thought about suicide. The researchers wanted to know if those at greatest risk of suicide could be identified and what proportion of those who thought about suicide would actually make an attempt at taking their own life.

“Thoughts of suicide (suicidal ideation) are common in young people and are a well-established risk factor for suicidal behaviour. However, we don’t know much about the factors that predict suicide attempts within this high-risk group. Our study is really important, as it is the first study to identify predictors of future suicide attempts at age 21 years among adolescents who had thought about suicide when they were aged 16 years,” Dr Becky Mars, author of the study and a research fellow at the University of Bristol told Theravive.

The researchers found that of the teenagers who had suicidal thoughts, 12 per cent attempted suicide in a five year follow up period. Those who had suicidal thoughts and engaged in self harm at aged 16 were considered particularly high risk, with one in five in this group attempting suicide in a five year follow up.  

“Most people with suicidal thoughts will not make an attempt on their life – we found that only 12 per cent of those who thought about suicide in adolescence went on to make a suicide attempt by the time they were 21 years old,” Mars said.

A number of factors were studied to determine which are the best predictors of suicide attempts. The researchers found that the best predictors were exposure to self-harm in family or friends, illicit drug use or use of cannabis, non-suicidal self-harm and having a personally type considered to be open to new experiences.  

Among those who engaged in non-suicidal self-harm at age 16, the best predictors for suicide were cannabis or drug use, a less extroverted personality or having sleep problems.

“We were not really surprised by the predictors we found. Similar to previous studies, we also found that many of the risk factors we looked at such as mental health problems, impulsivity and hopelessness were not very good predictors of future suicide attempts among those who had thought about suicide,” Mars told Theravive.

The researchers say the findings suggest that the reason someone has thoughts of suicide may differ from the reasons why someone may then attempt to act on those thoughts. In order to identify teenagers at greatest risk of suicide, she says it is essential experts learn more about how thought may indicate future action.

“Asking about factors such as substance use, non-suicidal self-harm, personality traits, and exposure to self-harm may help clinicians to identify which young people are in greatest need of timely help, support and interventions,” she said.

According to the US Centers for Disease Control and Prevention, suicide is a leading cause of death in the United States with 45 thousand people dying by suicide in 2016. Suicide is the second leading cause of death for those aged 10 to 34, behind unintentional injury.

The rate of suicide in the US has risen by 30 per cent in more than half of US states since 1999. Every day, roughly 123 Americans die by suicide, or one death by suicide every 12 minutes.

Suicide is four times higher in men than in women in the United States, yet females are more likely than males to have suicidal thoughts.

The authors of the study intend to expand their research and examine predictors for shorter time frames of just weeks, days and hours. They also hope to examine other predictors not included in this study.

They note that one in six young people reports attempting self-harm, yet suicide attempts are relatively rare. They say that being able to identify those who are at greatest risk from moving to suicidal thoughts to a suicide attempt will enable better interventions, and save more lives.