Suicidal and nonsuicidal self-harm behaviors in adolescent substance use disorders

Suicide deaths and suicidal behaviors among adolescents are a significant public health burden. They often occur in the context of treatable mental health and substance use problems (Beautrais, 2003; Brent et al., 1988; Shaffer et al., 1996), are associated with a large number of productive years lost to society, and significantly impact the lives of suicide survivors, often in traumatic ways (Jordan amp McMenamy, 2004). Nonlethal suicidal behaviors are associated with increased risk for additional nonlethal suicidal behavior (Goldston et al., 1999; Joiner et al., 2005) and increased rates of suicide death (Lonnqvist amp Ostamo, 1991), and are a major reason for child psychiatric hospitalizations and emergency room presentations (Peterson, Zhang, Santa Lucia, King, amp Lewis, 1996). Nonsuicidal self-harm behavior also has been an area of increasing public health concern and appears to be related to significant psychological distress among young people (Nixon, Cloutier, amp Aggarwal, 2002; Nock amp Prinstein, 2004, 2005).