College students' views on suicide.

College students were asked to rate the acceptability of suicide for themselves and for others in various circumstances. It was hypothesized that acceptability would vary as a function of circumstance of the suicide, the students' religious affiliation, history of past attempts, and whether the suicide was contemplated for oneself or another. The authors found that the highest acceptability for suicide was in the circumstances of terminal or chronic illness and depression. Students affiliated with organized religion were less accepting of suicide than were the individuals without such an affiliation. Previous suicide attempts were associated with greater acceptance of suicide for oneself or for others. In general, participants were more likely to accept suicide for others than for themselves, but the individuals who had previously attempted suicide displayed the opposite pattern under the circumstance of depression. Implications of these findings and directions for further research are discussed.

Self-reported depressive symptoms in inner-city adolescents seeking routine health care.

This study examines the self-reported depressive symptoms of inner-city adolescents coming to a health center for routine care. Data were obtained from a confidential screening questionnaire. Of the 966 adolescents responding to questions about depression, 371 (38%) indicated never being down or depressed. Five hundred and seventy three indicated the frequency of their being down or depressed as follows: 446 (78%) infrequent (once a month or less) and 127 (22%) frequent (weekly or more often). Relationships between frequently feeling down or depressed and eight somatic and twelve psychosocial concerns were explored. A relative risk for frequently feeling down or depressed greater than threefold was found for six of these concerns, all psychosocial in nature. These data suggest that one-fifth of the teens coming for routine health care also reported frequent feelings of being down or depressed when specifically asked about such feelings. Identification of such teens may be facilitated by inquiries into specific somatic and psychosocial concerns. Follow-up care is also reviewed. Since adolescents do not routinely seek help for mental health concerns, health providers seeing adolescents for general health care should actively solicit information relating to such concerns.

Lidocaine as a diluent for ceftriaxone in the treatment of gonorrhea. Does it reduce the pain of the injection?

OBJECTIVE: To compare the pain associated with ceftriaxone sodium injections by using two different diluents, ie, lidocaine hydrochloride and sterile water. DESIGN: Prospective study of adolescents who were culture positive for gonorrhea. Random selection of the diluent used for the intramuscular ceftriaxone therapy. SETTING: Urban, hospital-based adolescent medicine service. SUBJECTS: Thirty-nine adolescents and young adults, predominantly of black or Hispanic backgrounds, ranging in age between 14 and 23 years (mean age, 17.6 years; median age, 17 years), of whom 27 were females. METHODS: Pain predictions were elicited from the adolescents before treatment. Pain ratings were obtained at five time intervals after the injections. All ratings were obtained by using a visual analog scale. RESULTS: No pain prediction differences before the injection were noted between the two groups. Individual t tests showed significant pain differences between the two groups at the time after the injection and at 10- and 20-minute and 6-hour intervals. Repeated-measures analysis of variance models showed that the diluent effect on pain was significant. CONCLUSION: Lidocaine can reduce the amount of pain of an intramuscular injection of ceftriaxone when compared with sterile water as a diluent. These findings have implications not only for the treatment of gonorrhea but also for other situations where intramuscular injections utilizing a diluent may be necessary.

Seat belt use and stress in adolescents.

This study explored the association of adolescent seat belt use with psychosocial risk factors in an urban minority population after the enactment of a mandatory seat belt law. Data on seat belt use, family support, feelings of being down, suicidal ideation, substance abuse, sexual activity, school troubles, and problems with the law were obtained from 541 self-report intake forms administered to an adolescent medicine clinic population from 1986 to 1987. Respondents were almost exclusively black and Hispanic; 315 (59%) were females and 222 (41%) males, with a mean age of 15.4. Seat belt use was reported by 249 (46%) and no or intermittent use by 292 (54%). Chi-square and Wilcoxon rank sums tests were used to examine associations between seat belt use and risk factors. Results showed that the group comprised of those reporting no and intermittent seat belt use was significantly more likely to feel down, have decreased home support, have problems with school and the law, have been on probation, and feel that life in general was not going very well. No association was found between seat belt use and cigarette, drug, or alcohol use or sexual activity without contraceptives. Taking into account the lack of observed behavioral information to validate such self-report questionnaires, these data nevertheless point to the nonuse or intermittent use of seat belts as a possible manifestation of a lack of self-care due to feeling down and/or preoccupation with family, school, or societal problems.