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Long-Term Impact of Exposure to Suicide: A Three-Year Controlled Follow-up

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ABSTRACT

Objective

To determine the long-term impact of exposure to suicide on the friends of adolescent suicide victims.

Method

One hundred sixty-six friends of suicide victims and unexposed community controls were followed up at periodic intervals up to 3 years after the suicide, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Epidemiologic and Present Episode versions, to assess current and incident psychopathology.

Results

The incidence of suicide attempts was comparable between groups over the entire follow-up period, despite higher rates of baseline and incident psychopathology in the exposed group. An increased incidence of depression and anxiety was found in friends that was most marked in the first 6 months of follow-up. An increased incidence of posttraumatic stress disorder (PTSD) in those exposed was seen in the early as well as the later periods of follow-up. Those exposed youths who knew the suicide plans of the suicide victim were at the greatest risk for incident depression and PTSD over the entire course of follow-up.

Conclusion

Exposure to suicide does not result in an increased risk of suicidal behavior among friends and acquaintances, but it has a relatively long impact in terms of increased incidence of depression, anxiety, and PTSD.

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This work was supported by NIMH grant MH 44711. The expert assistance of Patricia Nuss in preparation of the manuscript is gratefully acknowledged. Doreen Constantine, Laura Liotus, Claudia Roth and Joy Schweers provided interviewing and technical support for the study.

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