Teens who are bullied or spend excessive amounts of time on the internet may be at an increased risk of suicide, according to a new report from the American Academy of Pediatrics (AAP). The report, published online in the journal Pediatrics, points to the fact that suicide has risen to the second-leading cause of death among teens in the U.S., with 1,748 per 100,000 kids between the ages of 15 and 19 killing themselves in 2013.
The new report replaces a previous version published in 2007 when suicide was the third-leading cause of death for adolescents. It has now surpassed homicide, and only unintentional injuries such as motor vehicle accidents and inadvertent poisonings claim the lives of more teens.
And while the AAP reports risk factors for suicide attempts include a family history of suicide, a history of physical or sexual abuse, mood disorders, drug and alcohol use, questioning sexual identity or transsexual identification, bullying and excessive internet use have been added to the list.
“Bullying has always been a major issue for adolescents, but there is now greater recognition of the connection between bullying and suicide,” lead report author Benjamin Shain, MD, head of the Division of Child and Adolescent Psychiatry at North Shore University Health System, said in a news release. He noted that teens at greatest risk were those who were both bullies and victims.
Plus, the advent of social media has made it even worse for today’s teens. “The internet is a key influence, as well. Cyberbullying, for example is as serious problem as face-to-face bullying,“ Shain added.
Dewey Cornell, PhD, a clinical psychologist and director of the Virginia Youth Violence Project, agrees. “The internet can have a magnifying effect on bullying because the adolescent’s humiliation is public and he or she feels helpless to stop it from continuing,” Cornell, who was not involved in the study, told USA TODAY in an email. “It’s bad enough to be teased and rejected by a few classmates, but far worse when it is visible to all of your friends and potentially everyone in the world.”
The internet holds other perils for susceptible teens. According to the AAP report, “pathological internet use” – daily use of video games and internet exceeding five hours – is strongly associated with depression and suicidal thoughts and attempts in adolescents. In addition, suicide-related searches are associated with completed suicide among teens. Pro-suicide websites that describe methods in detail may prompt suicidal behaviors in at-risk teens.
The report also focused on the use of antidepressants to treat at-risk adolescents. In 2004, the Food and Drug Administration (FDA) directed pharmaceutical companies to label all antidepressant medications with a black-box warning of increased risk of suicidality in children and teens. However, results of subsequent studies suggest that, for appropriate youths, the risk of not prescribing these drugs is significantly higher than prescribing them. According to the AAP, antidepressant medications are a “valuable treatment option.”
To help curb teen suicides, the AAP recommends that pediatricians routinely ask teenage patients if they have thoughts of harming themselves, and screen for other factors associated with increased suicide risk.
