Familial Pathways to Suicidal Behavior — Understanding and Preventing Suicide among Adolescents

A 16-year-old boy whose brother recently committed suicide is seen in the emergency room after slashing his wrists. He reports having felt severely depressed and hopeless since his brother died and has markedly increased his alcohol intake. His depression actually began 4 years ago, after the death of his father, and has continued unabated. The patient has a history of being disciplined for fighting in school, usually after being teased or provoked by his peers. Immediately before his suicide attempt, he had a fight with his girlfriend, his mood plummeted, and he decided that he might as well be dead. . . .