Psychosocial conditions and suicidal behavior in pregnant teenagers - A case-control study in Brazil

Objective To compare the psychosocial profile and suicidal behavior of 110 pregnant teenagers (PT) with 110 nonpregnant teenagers (NPT). Method Subjects were matched by age and residential district. The research instruments used were a structured clinical interview and a self-reporting questionnaire based on psychometric scales whose answers were subjected to univariate and multivariate logistic regression. Results Prevalence in the PT and the NPT groups were found to be as follows: attempted suicide (20.0 vs. 6.3%); depression (26.3 vs. 13.6%); anxiety (43.6 vs. 28.0%). Univariate analysis revealed the following significant associations with pregnancy: relocation in the previous 3 years (odds ratio (OR) = 6); years of schooling <= 7 (OR = 3.4); repeating a year in school (OR = 2.4); dropping out of school (OR = 5.2); death of a parent during childhood (OR = 2.9); use of alcohol/drugs in the family (OR = 2.5); previous attempted suicide (OR = 3.6); suicide by a relative (OR = 2.1); threats of physical/sexual abuse (OR = 3.5); depression (OR = 2.2); low level of social support (OR = 4.2); traumatic events (OR = 5.1) and psychosocial difficulties (OR = 4.4); prior use of tobacco and marijuana (OR = 4.0 and 4.8 respectively); weekly intake of alcohol over the previous 12 months (OR = 4.2). Multivariate analysis identified the following associations: relocation (OR = 6.4); prior use of tobacco (OR = 2.9); dropping out of school for a period in excess of 6 months (OR = 2.3); suicide by a social acquaintance (OR = 2.5). Conclusion The PT case group exhibited a psychosocial profile whose characteristics clearly differentiate this group from the NPT control group. Preventive mental health care is needed to help PT because their behavioral pattern exposes them to high risk for suicide.