Adolescents who make suicide attempts repeatedly

Four hundred and six consecutive suicide attempts made by 15-19 year-old adolescents in 1973-1982 were examined. Two hundred and twenty-six cases were first, 180 repeated suicide attempts. Repeaters came from poorer social situations and less well integrated families than first-timers. Repeaters had many adapting problems typical of personality disorders and had previously been in psychiatric treatment. Their level of adaptive functioning (GAS) and overall functioning (DSM III: s axis V) were poorer than within first-timers. They were not psychotic more often than first-timers and did not make more difficult suicide attempts. Their psychiatric after-care was more intensive and prognosis with regard to subsequent suicide was poorer than within first-timers. At the end of follow-up time (approx. 5 years) 1% of first-timers and 4% of repeaters had committed suicide. Observed-expected ratio for first-timers was 0.58 and for repeaters 1.73.