In a review of pediatric hospital emergency room admissions over 7 years, the authors found 505 children and adolescents who had attempted suicide. There were three times as many girls as boys, and the boys were significantly younger. Features that distinguished them from matched controls were religion, living situation, substance abuse, current psychiatric illness, prior psychotherapy, and current medical illness. Their families had more psychiatric illness (primarily drug or alcohol abuse), suicide, paternal unemployment, and paternal and maternal absence than the controls' families. The suicide attempts usually occurred in the winter, after school or in the evening, at home with someone nearby, and by drug overdose.