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According to a new study conducted in part by a Yale researcher, daily smoking is significantly connected to suicide attempts and self-mutilation in teens hospitalized for psychiatric illnesses.

The study, published in the most recent Journal of Adolescent Medicine, included 157 boys and girls aged between 12-17 years who were admitted for mental illnesses to the Oulu University Hospital Department of Psychiatry in Finland.

“The University of Oulu — has an adolescent psychiatric unit that treats everyone who lives in northern Finland,” said Jaakko Lappalainen, associate professor of psychiatry at the Yale School of Medicine. “In this population — an association was found between smoking and suicide attempts and self-mutilation.”

Among adolescents who smoked daily, researchers discovered a four times greater risk of suicide attempts or suicidal thoughts and a three-fold greater risk of self-mutilation, when compared with nonsmoking young people.

In the population studied, an equal proportion of both boys and girls were daily smokers. However, researchers uncovered an inequity between genders with regard to suicidal intent and self-mutilation.

“There was a difference between males and females — at least in this population, the suicidal ideation and attempts were more common in this population among girls,” said Lappalainen. “This is consistent with previous findings.”

While this study was consistent with previous findings connecting smoking and suicidal behavior in general, it was of particular significance due to its results on self-mutilation, again showing a stronger correlation between smoking and mutilative behavior in girls.

“The novel finding in our study is that smoking was not only associated with definite suicide attempts, but also with self-mutilative behavior,” reads the study. “A surprisingly high proportion of the girls who smoked reported self-mutilative behavior — Self-mutilators commonly underestimate the lethality of their suicidal behavior and view death with less finality. In our study, the frequency of self-mutilative behavior among the young adolescent smoking girls is alarming and may indicate a greater risk for suicide in the future.”

The practical applications of the findings remain to be seen — Lappalainen said the study does not suggest a cause and effect relationship between smoking and psychiatric illness.

“It doesn’t really tell us anything about the causality of the association,” Lappalainen said. “We don’t think smoking would cause suicide — but [it may be one of many] symptoms of a behavior that is common for — mental illness in the adolescent population.”

The written study suggests that encouragement to quit smoking may help in the recovery from suicidal tendencies.

Other factors considered warning signs for mental illness include substance abuse and family problems, according to the National Institute of Mental Health Web site.

This study is part of a long-term project called “STUDY-70,” which was initiated at University of Oulu to examine the association of various psychosocial risk factors to the outcomes of serious psychiatric and substance abuse problems among young people aged 12–17 years, under treatment for psychiatric disorders.

Genetic research is being conducted at Yale, as a follow-up to the original study. Samples were taken from subjects and their parents to track the transmissions of gene forms associated with psychiatric illness, in what Lappalainen called a “family-based genetic study.”

The lead author of the study is Taru Makikyro, M.D., among other researchers at the University of Oulu.

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