Firearms and Adolescent Suicide: A Community Case-Control Study

doi:10.1001/archpedi.1993.02160340052013

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Vol. 147 No. 10, October 1993

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Firearms and Adolescent Suicide

A Community Case-Control Study

David A. Brent, MD; Joshua A. Perper, MD, LLB, MS; Grace Moritz, ACSW; Marianne Baugher, MA; Joy Schweers, MEd; Claudia Roth, MSW

Am J Dis Child. 1993;147(10):1066-1071.

Abstract

• Objective.
—To assess the association between firearms in the homeand adolescent suicide.

Research Design.
—Matched, case-control.

Setting.
—Population-based community sample.

Subjects.
—Sixty-seven adolescent suicide victims and a demographicallymatched group of 67 living community controls.

Selection Procedure.
—The series of adolescent suicide victims was consecutive,with an overall participation rate of 74% (67/91).

Measurements and Results.
—The presence, type (handgun vs long-gun), number, andmethod of storage (locked vs unlocked, loaded vs unloaded) offirearms in the home were compared between the suicide victimsand controls. Even after adjusting for differences in ratesof psychiatric disorders between suicide victims and controls,the association between suicide and both any gun (odds ratio[OR]=4.4, 95% confidence interval [Cl]=1.1 to 17.5) and handguns(OR=9.4,95% Cl=1.7 to 53.9) in the home were both highly significant.Long-guns in the home were associated with suicide only in ruralareas, whereas handguns were more closely associated with suicidein urban areas. Handguns (OR=12.9, 95% Cl=1.5 to 110.9) andloaded guns (OR=32.3, 95% Cl=2.5 to 413.4) in the home wereparticularly significant risk factors for suicide in those withno apparent psychiatric disorder.

Conclusions.
—When pediatricians are faced with a suicidal adolescent,they should insist on the removal of firearms from the home.Pediatricians should also inform parents that the presence offirearms may be associated with adolescent suicide even in theabsence of clear psychiatric illness.

(AJDC. 1993;147;1066-1071)

Author Affiliations

From the University of Pittsburgh (Pa) School of Medicine and the Western Psychiatric Institute and Clinic (Dr Brent and Mss Moritz, Baugher, Schweers, and Roth); and the Allegheny County Coroner's Office, Pittsburgh (Dr Perper).

Footnotes

Accepted for publication April 5, 1993.

Reprint requests to University of Pittsburgh School of Medicine,Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh,PA 15213 (Dr Brent).

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