(Reuters Health) - Suicide attempts are rising among black teens in the U.S. even as they fall among youth from other racial and ethnic groups, a study suggests.

Researchers examined nationwide survey data from nearly 200,000 high school students collected between 1991 and 2017. While the overall proportion of teens reporting suicidal thoughts or plans declined for all racial and ethnic groups during the study period, the proportion of black teens attempting suicide surged by 73%.

“Whatever is happening to result in a downward trend among teens in the general population is missing black teens,” said Michael Lindsey, lead author of the study and executive director of the McSilver Institute for Poverty Policy and Research at New York University.

Overall, 7.9% of teens attempted suicide during the study, and 2.5% sustained injuries as a result. Almost one in five teens reported suicidal thoughts and 14.7% planned a suicide, researchers report in Pediatrics.

Self-reported suicide attempts rose in black teenagers, even as they fell or followed no significant pattern in white, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native teenagers, the study found.

While suicide attempts decreased among teen girls overall, they increased among black teen girls.

There was also a surge in injuries from suicide attempts among black teen boys.

More research is needed to determine why traditional precursors to suicide attempts like thinking about or planning a suicide are decreasing while actual attempts are going up, Lindsey said by email.

The current study can’t explain why suicide attempts and injuries are rising among only certain groups of youth.

“We believe that it’s important for parents, mental health service providers and school personnel to learn the signs of depression in black youth,” Lindsey said. “We know that suicidality can stem from untreated depression and, in addition to the classic signs of depression, such as becoming withdrawn or having a depressed mood, black teens may present with physical complaints, such as persistent headaches or stomach aches or with interpersonal challenges, such as angry outbursts, which may be construed as behavioral problems rather than cries for help.”

A separate study in Pediatrics looked at suicide rates for cisgender teens - youth whose gender identity matches their sex assigned at birth - and for transgender teens - whose gender identity does not match their sex assigned at birth.

This study examined online survey data from 2,020 teens ages 14 to 18, including 1,134 who identified as transgender.

Compared to their cisgender counterparts, trans teens were more than twice as likely to report having a death wish or suicidal thoughts. Trans youth were also 82% more likely to plan a suicide and 65% more likely to attempt suicide.

“Trans teens are under much greater potential societal pressure, such as parental disapproval, bullying, and difficulty in finding romantic and other friends,” said Dr. Benjamin Shain of NorthShore University HealthSystem in Deerfield, Illinois and the University of Chicago Pritzker School of Medicine.

Teens are increasingly in danger for suicide and from related mental health problems such as depression, Shain, author of an editorial accompanying the studies in Pediatrics, said by email.

Parents should keep an eye out for evidence of depression, severe mood changes, substance misuse or suicidal thoughts or behaviors, Shain advised.

Other warning signs may involve changes in how teens behave in school or in relationships with friends and peers, Shain said.

In particular, parents should get help for teens when they see a “change in functioning such as lower grades, less interest in activities, isolating from friends and/or family, or dangerous or impulsive behaviors,” Shain added.

SOURCE: bit.ly/2MBKCbu Pediatrics, online October 14, 2019.