Abstract This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case–control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included adolescents, individually matched according to gender, age and time between interview and suicide/admission, who had been admitted to a Psychiatric Department with suicidal ideation or attempted suicide at admission. Results showed that suicide victims had been exposed more frequently to suicidal behaviour by friends and through media and experienced more relational problems in the past year. Suicidal communication was less frequently reported in suicide victims than in controls and when communication did occur, it was less often directed towards parents. Treatment of psychiatric disorders was significantly less found in suicide victims. Psychiatric control patients were more likely to have comorbidity of psychiatric disorder, conduct disorder, delinquency or academic difficulties. This study showed significant differences between young suicide victims and psychiatric controls for life events, exposure, communication and treatment. These results also suggest that more symptoms and more externalizing behaviour can be observed in psychiatric control patients which could indicate more warning signals of possible psychiatric problems for the environment, which could result in more help-seeking behaviour and treatment.