Suicide and suicidality in children and adolescents with chronic illness: A systematic review

Abstract

Suicide is currently the second leading cause of death for children and adolescents. Evidence suggests that the presence of a chronic medical illness is an independent risk factor for suicidality and completed suicide in both youth and adults. In addition, the period of childhood and adolescence is already a time of marked vulnerability for psychiatric disorders and suicidality, and youth with medical conditions or chronic illnesses are at an even greater risk for suicide. Previous research has identified elevated risk of suicidality in youth with chronic illness; however, the specific risk factors, psychiatric comorbidities, and etiology for suicide and related behaviors are unique, differ by illness, and are far less understood. The current systematic review provides an evaluation and synthesis of empirical literature from the past 30 years that investigated the relationship between specific chronic illnesses, suicide, and suicidality in a pediatric (under 18) population. Results of this synthesis demonstrate that the effects of chronic illness on youth suicidality are not homogenous as the pathways and risk factors can vary greatly for each specific disease. Given the considerable etiological heterogeneity for suicidality, this review provides clinicians and medical professionals with a clearer pathway to identification and delineation of risks for suicidality in specific illnesses allowing for better informed and more accurate interventions for children and adolescents with chronic illnesses who are at risk for suicide.