Firearms and Adolescent Suicide

OBJECTIVE: To assess the association between firearms in the home and adolescent suicide. RESEARCH DESIGN: Matched, case-control. SETTING: Population-based community sample. SUBJECTS: Sixty-seven adolescent suicide victims and a demographically matched 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 (hand-gun vs long-gun), number, and method of storage (locked vs unlocked, loaded vs unloaded) of firearms in the home were compared between the suicide victims and controls. Even after adjusting for differences in rates of psychiatric disorders between suicide victims and controls, the association between suicide and both any gun (odds ratio OR = 4.4, 95% confidence interval CI = 1.1 to 17.5) and handguns (OR = 9.4, 95% CI = 1.7 to 53.9) in the home were both highly significant. Long-guns in the home were associated with suicide only in rural areas, whereas handguns were more closely associated with suicide in urban areas. Handguns (OR = 12.9, 95% CI = 1.5 to 110.9) and loaded guns (OR = 32.3, 95% CI = 2.5 to 413.4) in the home were particularly significant risk factors for suicide in those with no 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 of firearms may be associated with adolescent suicide even in the absence of clear psychiatric illness.