Suicides among youths 10 to 19 are rising faster than predicted, creating a potential public health crisis.

That's the conclusion of the study, "Suicide Trends Among Youths Aged 10 to 19 Years in the United States, 1996-2005," which appeared today in the Journal of the American Medical Association. The study stresses the need for further studies to determine precisely why more youths are killing themselves.

"If we expand efforts to identify children at risk earlier, we will do a better job at preventing suicides," said Jeffrey A. Bridge, an Ohio State University epidemiologist who led the study at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio.

The study used death totals from the National Vital Statistics Systems to determine that 1,983 youngsters committed suicide in 2004 -- a 14.5 percent jump over 2003 and marked spike upward after a decade-long decline in suicides. Although the number dropped to 1,883 in 2005, it still was markedly higher than would have been expected.

The numbers could signal a troublesome turnaround, the study found.

The annual number of suicides had been dropping steadily since 1990, even though the study focused on numbers since 1996. More recent numbers show a drop from 1,921 in 2000 to 1,731 in 2003.

"Attention must now be directed toward understanding whether this increase in the youth suicide rate after a decade-long decline reflects an emerging public health crisis," Dr. Bridge's research letter states.

Reduction in suicides from 1996 to 2003 can be traced, in part, to public campaigns to convince parents to lock up guns inside the home, said Joel B. Greenhouse, a Carnegie Mellon University professor of statistics and study participant.

The recent spike could reflect the impact of a 2003 warning from the Food and Drug Administration that led to a black-box warning in 2004 on all antidepressants urging caution in prescribing them to youths. But that warning, Dr. Greenhouse said, was based on studies that excluded children at high risk for suicide, providing results that might not be applicable to the general population.

He recommended a study to track whether there's a link between higher suicide rates and the decline in antidepressant prescriptions for at-risk young people.

Other possible causes include teenage suicides among those who served in Iraq and Afghanistan and the impact of the social networking over the Internet, where means of suicide often are discussed, the study said.

Dr. David A. Brent, director of Services for Teens at Risk at University of Pittsburgh Medical Center's Western Psychiatric Institute & Clinic, said the numbers do raise concern. Since the FDA issued its black-box warning, he said, there's been a decline in the number of youth being diagnosed and treated for depression. Other concerns are availability of guns, alcohol and drug use and economic problems.

"But we should have been just as concerned about suicide years ago," Dr. Brent said. "If a kid is showing a change in function and mood and expressing thoughts of suicide, it's time to get him or her evaluated. That would be true even if the suicide rate were zero. Those conditions are impairing and interfering with their development."