Adolescent and Young Adult Suicide and Self-harm: Exploring Changes in Risk Factors from 2016 to 2023

Introduction: From 2014 to 2022, the suicide rate among adolescents and young adults in Taiwan doubled. Self-harm is recognized as a significant risk factor for suicide. This study aimed to examine changes in the predisposing factors for suicide and self-harm in this population over time. Methods: We included individuals under 25 years of age who were reported to the National Suicide Surveillance System for suicidal or self-harm behaviors at a medical center in Tainan from 2016 to 2023. We conducted a retrospective review of comprehensive patient histories and outcomes. Results: The study included 648 individuals under 25 years of age, with a median age of 20 years and 75.6% of female participants. The cohort included 270 individuals from the early period (2016–2019) and 378 from the late period (2020–2023). Logistic regression analysis revealed significant changes in factors between the two periods. Compared with the early period, the late period was associated with increased rates of depressive disorder (adjusted odds ratio [aOR]: 2.23, 95% confidence interval [CI]: 1.54–3.23) and bipolar disorder (aOR: 3.77, 95% CI: 1.81–7.85). Taking a leave of absence (aOR: 3.63, 95% CI: 2.28–5.78, P < 0.001), child abuse (aOR: 3.52, 95% CI: 1.79–6.94, P < 0.001), and domestic violence (aOR: 2.37, 95% CI: 1.11–5.08, P = 0.03) also significantly increased. In contrast, suicide at home (aOR: 0.55, 95% CI: 0.38–0.79, P = 0.001) decreased significantly. Conclusion: The social and psychological landscape of adolescents and young adults has shifted, requiring tailored strategies to address these evolving risks.