Autolesiones y conducta suicida en niños y adolescentes. Lo que la pandemia nos ha desvelado

Abstract

IntroductionSuicidal behavior and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviors. MethodsNarrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviors in pediatric emergencies. ResultsMental health consultations were analyzed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the Spanish Society of Pediatric Emergencies (SEUP), finding a 122% increase of the diagnosis of «non-accidental drug intoxication» and 56% of «suicide/suicide attempt/suicidal ideation». In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1%), 14.8 years old, 34.9% without previous psychiatric diagnosis; 57.7% with previous suicidal behavior. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behavior, although other factors are involved (family, personal or social). Pediatricians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. ConclusionsPrimary, hospital and mental health care resources for pediatric population should be strengthened to prevent suicidal behaviors. Specific training for school staff, and child and adolescent psychiatry training for pediatricians and nurses are crucial in the prevention of suicide in children and adolescent population.