RESUMO
The management of adolescent suicidal behavior in the practices of 48 pediatricians from Rochester and Syracuse, New York, was reviewed in the context of a rising local and national incidence. Alternative resources were found to be used much more heavily by suicidal adolescents in the two communities. Few pediatricians ask routinely about suicidal thoughts. The fatality rate is low enough to reinforce present practice, but suicidal symptoms are far more frequent than fatalities. It is hypothesized that avoidance of the issue by the pediatrician results in underutilization of this potentially valuable resource. Asking about the problem may result in a higher contact rate and, it is proposed, a better outcome. Depressive symptoms and appropriate responses to suicidal thinking are discussed.
Assuntos
Adolescente , Pediatria , Suicídio/epidemiologia , Comportamento do Adolescente , Feminino , Humanos , Entrevista Psicológica , Masculino , New York , Suicídio/psicologia , Tentativa de Suicídio/epidemiologia , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Inquéritos e Questionários , Prevenção do SuicídioRESUMO
Adolescents who have grand mal epilepsy and their parents were interviewed, and the adolescents were evaluated neurologically. Better seizure control and less neurologic disability were unexpectedly associated with less open communication between the adolescents and their families and friends, and with a poorer self-image and poorer expectations for the future. These findings were unrelated to IQ or school performance. This outcome is consistent with other studies of invisible defects and stigmatization, and suggests that youngsters who have relatively mild defects involving social disability may be more troubled than those with more apparent defects, for which denial may be operative. An incidental finding in the study was that a question more predictive of overall family, social, and academic function than the neurologic findings was simply whether or not the youngster was attending the appropriate grade in school for his or her age.