Suicidal behavior in adolescence is now well documented with regard to biological and psychological traits, family-environmental factors, and clinical management. In despite of this knowledge, few interventions are based on family therapy.

To examine the association between suicide attempt in the adolescent population in Quebec and family constellation with regard to family structure and family functioning adjusted for socio-economic factors.

Data: Social and Health Survey of Children and Adolescents in Quebec State performed in 1999 (Institut de la Statistique du Québec, Canada). Subjects: 1186 adolescents aged 13 years and 1160 adolescents aged 16, and their parents. Outcome: suicide attempt during lifetime. Independant variables: family structure, witnessing interparental violence and parental emotional support. Covariates: family socioeconomic background and demographic variables.

Statistics: logistic regression analysis.

81 adolescents reported one suicide attempt or more during lifetime, with a significant risk for girls but this risk was independant of age and ethnicity. The adolescents had a 2.5-fold higher risk of suicide attempt when they live in monoparental household (OR=2.46; 95% CI=[1.37-4.42]), a 3.8-fold higher risk when they witnessed interparental violence (OR=3.76; 95% CI=[2.10-6.74], and a 2 to 6-fold higher risk when parental support is low, particularly paternal support. These associations are not modified by familial socioeconomic status.

These results are concordant with family stress perspective in the un derstanding of suicidal beahvior in adolescents, and this independently of familial socio-economic deprivation. They give arguments for family centered therapy in the panel of interventions in health promotion in adolescence.