Tracking teen suicide attempters.

A new study suggests that concerned adults can best identify teenagers on the verge of a suicide attempt by directly asking them about recent feelings of hopelessness and thoughts about suicide. Previous studies indicated that distinguishing suicidal adolescents from their peers required a more extensive screening of prior mental problems, drug use, school failure and other factors.

One in 12 U.S. high school students attempted suicide last year, according to a national survey released last week by the Centers for Disease Control in Atlanta.

In search of clues to identify suicide-prone students, psychiatrist Susan E. Swedo of the National Institute of Mental Health in Bethesda, Md., and her co-workers studied 21 teens hospitalized after recent suicide attempts, 15 teens who had not attempted suicide but were considered at increased risk because of sexual abuse, drug abuse or severe depression, and a control group of 34 healthy teens.

Compared with the controls, attempters reported more drug abuse, depression and behavior problems, as well as poorer peer friendships, self-image and communication skills. But attempters differed from "at-risk" teens in only two respects. Attempters reported more hopelessness on a standard, 20-item questionnaire, and in three out of four cases, they said that at some time they had felt that life wasn't worth living and had considered suicide as a way out. Although many attempters cited a recent upsetting event -- such as harsh punishment by parents or a romatic breakup -- as the trigger for their suicide attempt, such incidents occurred just as often among the at-risk group, Swedo's team reports in the September PEDIATRICS.