Suicidal Behavior In Children Research Articles

The Association between Hyperactivity and Suicidal Behavior and Attempts among Children Referred from Emergency Departments.

The global prevalence of suicidal behaviors in children is rising, with attention-deficit hyperactivity disorder (ADHD) proposed as a contributing factor. This study examines the association between ADHD facets (hyperactivity and inattention) and suicidal behavior and attempts in children. Additionally, it seeks to compare self-reported ADHD symptoms and suicide-related incidents with parental reports. A cohort of 71 children referred from emergency departments due to suicidal thoughts and behaviors completed self- and parental report questionnaires. The results revealed that elevated hyperactivity scores, surpassing the ADHD diagnosis threshold, were significantly associated with increased rates of suicidal behavior. Hyperactivity demonstrated a stronger association with lifetime suicide attempts compared to inattention. Moreover, children's self-reported ADHD symptoms exhibited a stronger correlation with suicide attempts than parental reports. This study highlights the critical role of hyperactivity in understanding suicidal behaviors among children with ADHD. It underscores the importance of considering hyperactivity-related symptoms in assessment and treatment approaches for suicidal behavior in this population.

Responding to suicidal behaviour in children and young people with a child maltreatment history: A scoping review

Child maltreatment affects millions of children internationally every year. Development is negatively impacted by maltreatment increasing the likelihood of maladaptive behaviours. Associations between child maltreatment and suicidal behaviour and suicide in young people has been established. However, there is a research gap in understanding effective ways to respond to and intervene with suicidal behaviour in young people who have experienced child maltreatment. A scoping review was conducted in accordance with the Joanna Briggs Institute methodology to investigate interventions that may be effective in preventing and reducing suicidal behaviours in young people who have experienced child maltreatment. Inclusion criteria were studies: (a) of children and young people who engage in suicidal behaviour and have experienced child maltreatment; (b) published in English during the time period 2000–2020; and (c) focused on responses and interventions to prevent or address suicidal behaviour. Across 37 studies, several intervention targets were identified through reflexive thematic analysis including cultivation of self-compassion, gratitude and future orientation, alleviation of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms and psychological distress and addressing cognitive errors and negative views of the self. Screening and clear assessment of suicidal risk by health professionals and child welfare professionals was endorsed across studies. Several evidence-based treatments were proposed to support intervening with this client group, although only Emotional Intelligence Therapy (EIT) was empirically tested with this population. Utilisation of safe systems that the child or young person is in may be beneficial in addressing and reducing suicidal behaviour, such as inclusion of families, peers and the implementation of school-based interventions strategies. Future research is needed to empirically test and assess the effectiveness of interventions.

Longitudinal relationship between parent–child attachment and suicidal ideation in children: Mediating roles of beliefs about adversity and hope

Suicide has been an important topic in recent years, but no previous studies have investigated suicide from the perspective of parent–child attachment and positive psychological qualities. Thus, we aimed to examine the relationship between parent–child attachment and children's suicidal ideation, as well as the mechanism involved. In total, 681 fourth-grade students from three elementary schools in Suzhou, China, were surveyed for two years. The results showed the following. (1) Mother–child attachment directly predicted suicidal ideation in children whereas father–child attachment did not. (2) Mother–child attachment indirectly predicted suicidal ideation in children via beliefs about adversity and hope, and father–child attachment indirectly predicted suicidal ideation in children via beliefs about adversity. (3) Parent–child attachment indirectly predicted suicidal ideation in children through beliefs about adversity (M1) and hope (M2) as a mediator set. Revealing the mechanisms associated with the generation and formation of suicidal ideation in children can help prevent possible future suicidal behaviors in children.

Level 1 autism spectrum disorder as a risk factor for suicide in a child: case report

Introduction: Suicidal behavior is one in which the individual has thoughts, plans, and actions with the intention of ending their own life. This is a global public health problem. Recently, autism spectrum disorders have begun to be considered risk factor for suicidal behavior in children and adolescents. Method: Case report. Case presentation: A 12-year-old boy who made a suicide attempt, was admitted to the emergency department at Centro Psíquico da Adolescência e Infância. After a period of irregular treatment, this child made a suicide attempt. As an inpatient, autism spectrum disorder with comorbid depressive disorder was diagnosed after longitudinal and systematic assessments of multidisciplinary team. Treatment was performed according to clinical issues. Discussion: This patient had a form of autism spectrum disorder on which core aspects were not so evident. In this child, there was an overlap between depressive symptoms and symptoms of autism spectrum disorder. Despite social isolation being present, this patient proved capable to disguising his condition using techniques of social and behavioral imitation and camouflage with the aim of adapting to social environment. Conclusion: This study emphasizes the importance of longitudinal evaluation and multidisciplinary assessment to differential diagnosis and appropriate treatment. It also opens a window for further investigations of a possible association between autism spectrum disorders and suicidal behavior in youth.

Psychosocial Correlates of Suicidal Ideation and Behavior in Adolescents and Preadolescent Children Discharged from an Emergency Department in Israel

Objectives Adolescent suicidal behavior is highly prevalent in pediatric psychiatric emergency departments, and there is a growing occurrence of such behavior among preadolescent children. This study aims to examine the psychosocial factors associated with nonfatal suicidal behaviors in children (<12 years old) and adolescents (aged 12–18), to gain insight into unique and shared characteristics of suicidal behavior across these two age groups. Method This study investigates the psychosocial characteristics associated with suicidal ideation and behaviors in an emergency department sample of 183 children and adolescents aged 7–18 years in Israel. Participants completed a diagnostic interview, and self-report and parent-report questionnaires of psychosocial measures. Cross-sectional correlational and regression analyses were used to determine significant correlates of suicidal outcomes within the two age groups. Results Among adolescents, females exhibited a higher prevalence of suicidal thoughts and behaviors, while in children, both boys and girls showed similar rates. Depression correlated with suicidal ideation for both adolescents and children. In children, anxiety and conduct symptoms were associated with suicidal behavior, whereas in adolescents, suicidal behavior was associated with depression and anxiety. Conclusions The present findings contribute to the growing understanding of factors associated with suicidal thoughts and behaviors among children in comparison to adolescents. These findings underscore the importance of targeting specific risk factors when developing assessment and intervention strategies tailored to the two age groups.

Suicidal behaviour in children in Ghana: evidence from media reports

Suicidal behaviour in children in Ghana: evidence from media reports

Self-harm and suicidal behaviors in children: perspectives of mental health clinicians.

Presentations for self-harm and suicidal behaviors are increasing in children and young people, although less is known about these presentations in children aged 12 years and under. This study aims to understand how mental health clinicians in public health services conceptualize, identify and respond to self-harm and suicidal behaviors in children. 26 mental health clinicians provided their perspectives through interviews or focus groups. Participant responses were analyzed using reflexive thematic analysis. Mental health clinicians described how self-harm and suicidal behaviors may present differently in children compared with adolescents, particularly with the methods used. Using developmentally appropriate language and including parents or carers when screening for self-harm and suicidal behaviors was recommended by clinicians. The inclusion of parents or carers throughout the treatment process was important for clinicians, including helping parents understand their child's behavior and manage their own distress. Clinicians also highlighted the benefit of collaborating with schools to support children, yet noted primary school staff require training in responding to child self-harm and suicidal behavior. The limited services available for children 12 years and under including emergency care services, was identified as a problem. Findings highlight the importance of timely assessment and interventions which include mental health and medical clinicians, parents, carers, and school staff to support children with self-harm and suicidal behaviors.

483. Peripheral Biological Correlates of Suicidal Ideation and Suicidal Behavior in Children and Adolescents: A Systematic Review

483. Peripheral Biological Correlates of Suicidal Ideation and Suicidal Behavior in Children and Adolescents: A Systematic Review

Impact of COVID-19 restrictions on self-poisoning behaviour with mild analgesics in Danish youth

Background The COVID-19 pandemic prompted the implementation of precautions to contain the disease, including lockdowns and social isolation. Previous studies have investigated suicide rates among children and adolescents during the pandemic and have found varying results. We speculated how the two lockdowns influenced suicidal behaviour in children and adolescents in Denmark. Objective This study aimed to investigate the effect of lockdowns during the COVID-19 pandemic on suicide attempts, as measured by the incidence rate in all self-poisonings with mild analgesics among children and adolescents. Methods This national Danish registry-based study on children and adolescents used Poisson regression and interrupted time series analysis to examine the incidence rates and trends of self-poisonings with mild analgesics from 2019 to mid-2021. Results For the period of this study, 1655 self-poisonings were registered. During the first lockdown, there was a slight, not statistically significant, decrease in self-poisoning rates (incidence rate ratio [IRR]) 0.98) compared to no lockdown. During the second lockdown, there was a significant increase in self-poisonings for the whole Danish population (IRR 1.85) with girls being slightly higher at risk (IRR 1.87). Being a girl or between the ages of 13–17 years old were risk factors for self-poisoning. Conclusion These findings indicate that the restrictions enforced during the second lockdown greatly impacted youth mental health, especially girls, leading to an 85% increase in self-poisonings. We hope for increased awareness of mental health in children and adolescents during possible future lockdowns.

Antidepressants and suicide risk in children and adolescents

IntroductionIn recent years, the prescription of antidepressants for children has faced significant scrutiny due to studies suggesting an elevated risk of suicide among those treated with these medications. The primary objective of this study is to examine the causal connection between antidepressant use and suicidal behavior in children and adolescents.ObjectivesIn this article, we will examine the current research on this topic and discuss the current status of practical guidelines and recommendations for prescribing antidepressants to children and adolescents.MethodsWe conducted a literature review using the Google Scholar database, employing keywords such as antidepressants, suicide, children, and adolescents.ResultsThe literature yielded conflicting data. While it has been established that SSRIs moderately elevate the risk of suicide ideation and attempts, with venlafaxine, paroxetine, and sertraline showing a higher risk compared to other SSRIs like fluoxetine and citalopram, several studies indicate that their use is linked to a noteworthy reduction in suicide rates among children and adolescents.ConclusionsThe existence of a definitive causal relationship between antidepressants and suicidality in children and adolescents is currently uncertain, and the underlying mechanisms remain inadequately understood.Disclosure of InterestNone Declared

Evaluation of COVID-19 Effect on Mental Health, Self-Harm, and Suicidal Behaviors in Children and Adolescents Population

Objectives: The impact of the COVID-19 pandemic on the psychological state of the under-18 population includes an increased risk of psychopathological symptoms development and exacerbation of already present psychiatric disorders. This study aimed to assess the prevalence of mental health problems in Polish children and adolescents with a focus on suicidal and self-harm behavior with the impact of the pandemic. Methods: The questionnaire collected demographic data, information regarding mental states and psychopathological symptoms, history of self-harm and suicidal behaviors, as well as the experience of psychological, and physical violence, and suicidal self-harm behaviors before and during the COVID-19 pandemic. Results: In the final analysis, 782 responses were included. Self-evaluation of general and mental health scores was significantly lower during the pandemic among children (both p &lt; 0.001) and adolescents (both p &lt; 0.001). Moreover, general and mental health scores were lower among adolescents compared to children before (both p &lt; 0.001) and during (both p &lt; 0.001) the pandemic. The frequency of seeking help because of mental health problems increased during the pandemic among children and adolescents, while no changes were observed in the prevalence of psychiatric hospitalizations in either of the populations (p = 0.317 and p = 1.00, respectively). Out of autoregressive behaviors among children during the pandemic period, only the frequency of thinking about death increased (p = 0.038). No suicidal attempts were undertaken by children in either of the evaluated time periods. The presence of all autoaggressive behaviors was greater among adolescents compared to children both before and during the COVID-19 pandemic (all p&lt;0.05). Conclusions: A subjective decrease in psychophysical well-being, an increase in the frequency of seeking mental health help during the pandemic, as well as an increased prevalence of depressive and anxiety symptoms were observed in the under-18 population as a potential consequence of the COVID-19 pandemic and related socioeconomic changes. The marked increase in self-harm behavior in the adolescent population (age &gt; 12) and the marked increase in the frequency of death thinking in children (age ≤ 12) suggests the need for greater awareness and easier access to professional help from mental health specialists, particularly in a time of unprecedented stress and social isolation.

Suicidal Behaviors in Children and Adolescents: Synthesis of Issues and Solutions From Global Perspectives

Suicidal Behaviors in Children and Adolescents: Synthesis of Issues and Solutions From Global Perspectives

Protective factors of suicidal behaviors in children and adolescents/young adults: A literature review

BackgroundSuicidal behaviors present a public health challenge in children and adolescents. Although the risk factors have long been well documented, protective factors have only been documented for a few years, and there has not been a literature review concerning the suicidal behaviors of children and adolescents since 2006. MethodsRelevant articles were collected using the Medline/PubMed, Web of Science, and ScienceDirect databases. Studies meeting the following inclusion criteria were included: age of participants from 6 to 19 years, qualitative and quantitative cohort or case–control studies, multivariate analysis studies, and studies with significant results for at least one protective factor. The methodology used in this review is based on the PRISMA criteria. ResultsA total of 26 studies were included in this review, which highlights various individual and environmental protective factors. The results were too heterogeneous to perform a meta-analysis, and therefore the discussion is in the form of a narrative summary. High-quality relationships with family and in the school environment were the most frequently found protective factors. The presence of positive links with peers, with other adults, and with the culture of origin was also noted. On an individual level, self-esteem, emotional intelligence, and particular coping abilities were found to be the most important protective factors. ConclusionThere are numerous important protective factors for suicidal behaviors in children and adolescents and also for adapting care to their needs. A future challenge will be to determine the best protective factors to be consolidated or strengthened using self-assessment tools that are already in use or being developed.

Association Between Antidepressant Use and the Risk of Suicide in Children and Adolescents

In recent years, the prescription of antidepressants for children has come under serious scrutiny, as some studies have shown an increased risk of suicide among those treated in this way. The main aim of this study is to investigate the causal relationship between antidepressant use and suicidal behaviour in children and adolescents. We reviewed the literature on the Google Scholar, pubmed, science direct database. The data in the literature were contradictory; while it has now been demonstrated that SSRIs very moderately increase the risk of suicide ideation and attempts, with venlafaxine, paroxetine and sertraline in particular showing a higher risk than other SSRIs such as fluoxetine and citalopram, several studies show that their use is associated with a significant reduction in suicide rates in children and adolescents. There is currently no certainty of a causal relationship between antidepressants and suicidality in children and adolescents, so the mechanisms are still poorly understood.

Perspectives on the Study of Suicidal Behavior in Children and Adolescents: A Systematic Review of the Literature Using Graph Theory

En las últimas décadas se ha incrementado el número de investigaciones sobre el comportamiento suicida en la infancia y la adolescencia, sin embargo, no existen estudios en la actualidad que caractericen la producción científica en perspectivas de investigación. El objetivo de este artículo es caracterizar las perspectivas dominantes de investigación sobre el comportamiento suicida, factores de riesgo y predictores a nivel biopsicosocial en niños(as) y adolescentes. La búsqueda bibliográfica se efectuó en la base de datos Web of Science. Para el manejo de la información se realizó un análisis de citaciones y de clusterización mediante teoría de grafos. Se empleó las herramientas Sci2 Tool y Gephi. Se encontraron tres orientaciones investigativas dominantes enfocadas al análisis de los predictores psiquiátricos de la conducta suicida (1), la relación entre autolesión no suicida y la conducta suicida (2) y el abuso infantil y su relación con la conducta suicida (3). Se espera que este estudio contribuya a la comprensión de las múltiples aristas investigativas sobre el comportamiento suicida en la infancia y la adolescencia. Al mismo tiempo, la metodología utilizada enriquece el campo de estudio al reflejar con precisión su situación actual a nivel investigativo.

Self-injury and suicidal behavior in children and youth population: Learning from the pandemic

IntroductionSuicidal behaviour 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 behaviours. MethodsNarrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviours in paediatric emergencies. ResultsMental health consultations were analysed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the SEUP (Spanish Society of Pediatric Emergencies), 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 behaviour. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behaviour, 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 paediatric population should be strengthened to prevent suicidal behaviours. Specific training for school staff, and child and adolescent psychiatry training for paediatricians and nurses are crucial in the prevention of suicide in children and adolescent population.

Affiliation to a Social Group as a Preventive Factor in Suicidal Behaviors in Children and Adolescents during the COVID-19 Pandemic

Suicide is one of the most common causes of death in the population of children and adolescents. Available data show the continuous growth of this phenomenon and the ineffectiveness of prevention programs. Additionally, the COVID-19 pandemic significantly affected young people's mental health, including an increased risk of suicidal behaviors due to limited direct contact with the school and peer groups in favor of the home environment. Therefore, the aim of this narrative review was to consider the risk factors and protective factors for suicidal behavior in the under-18 population, with a particular focus on the importance of belonging to a social group and building identification with it as a phenomenon protecting against suicidal behavior. Additionally, in this review, we evaluate how the COVID-19 pandemic affected these relationships. The PubMed database was used in the search with the following keywords: suicide, suicide behaviors, child and adolescent suicide behaviors, group affiliation, family affiliation, ethnicity, religious affiliation, and the COVID-19 pandemic, with articles published between 2002 and 2022 analyzed. Research conducted to date indicates that both sustained and stable family and peer relationships, as well as a sense of identification and belonging, noticeably reduce the risk of suicidal behavior. Ethnic or cultural affiliation seems to have been particularly important during the isolation in the home environment caused by the COVID-19 pandemic. Additionally, it has been shown that while in lockdown, contact through social media with individuals' identification groups was associated with a reduced chance of emotional crises. Furthermore, regardless of cultural background, attachment to a particular group correlates with enhanced psychiatric state of children and adolescents. Thus, available data highlight the need for building and maintaining affiliations with suitable groups as a protective factor against suicidal behaviors.

Suicide and Suicidality in Children and Adolescents with Chronic Skin Disorders: A Systematic Review

Suicide in young children is rare; the incidence increases towards the end of adolescence. Skin disorders confer a high prevalence of psychiatric and psycho-logical comorbidities. However, published research on suicidal behaviour in adolescents and children with skin disorders is sparse. The aim of this study was to identify the prevalence of suicidal behaviour in children and adolescents under 18 years of age with chronic skin disorders and associated contributing risk factors. MEDLINE, PsycINFO, EMBASE, CINAHL and Cochrane databases were searched from inception to October 2020 for suicide or suicide attempts in patients under 18 years old with chronic skin disorders. The study protocol was logged on PROSPERO (CRD42020083528). Returned texts were reviewed independently by 2 authors. Bias was assessed according to Joanna Briggs Institute criteria. Five studies met the inclusion criteria; 4 cross-sectional surveys and 1 retrospective matched-cohort study. A total of 31,641 patients with acne, atopic dermatitis, body dysmorphic disorder or psoriasis were identified. Prevalence of suicidal ideation was 0.45% (psoriasis) to 67% (body dysmorphic disorder). The prevalence of suicidal attempts ranged from 0.08% (psoriasis) to 21.9% (acne). Patients with acne or atopic dermatitis had significantly increased odds ratio for suicidal attempts. Meta-analysis could not be performed owing to the heterogeneity and sparsity of data. Suicidal risk in skin disorders amongst adolescents and children under the age of 18 years old is broad and complex. The suicidal risk remained after adjusting for depression, suggestive of an alternative mechanism.

Urgent issues of suicidal behavior in children and adolescents (general and regional aspects)

The article deals with the issue of suicidal behavior in children and adolescents in the context of the realities of modern society. There has been an increase in juvenile suicides in Russia in recent years, with an overall average decrease in suicide rates. An attempt is made to consider these facts in the context of social and biological aspects affecting the formation of behavioral disorders. The phenomenon of «fragmentary» or «clip» thinking, characteristic of the modern youth subculture, as well as the role of social and neurobiological factors in the formation of suicidal behavior, is discussed. The results of a retrospective analysis of complex posthumous forensic psychological and psychiatric examinations of completed suicides of children and adolescents in the Republic of Buryatia for the period 2012–2016 are presented. It has been found that male teenagers (15–17 years old) who lived in rural areas, were brought up in single-parent families, and studied at a secondary school predominate. In 21.8 % of cases, there was a history of suicide in close relatives and every fifth suicidal child had signs of suicidal behavior earlier (suicidal statements, attempts, interest in the topic of suicide). In most of the studied cases, family conflicts were the probable causes of suicidal behavior. It is concluded that in order to analyze the issue of suicide in children and adolescents, a comprehensive assessment of social, ethno-cultural, and biological factors is necessary.

The Experience of the Crisis Clinic at the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva.

Suicidal behavior by children and adolescents has been and remains one of the most intractable of our social ills. Despite the general downward trend in suicide rates, children and adolescents remain one of the most at-risk groups. Suicidal behavior in all its manifestations is a biopsychosocial problem in which the superiority of one approach or the other cannot be unambiguously justified. It flows from this that strategies that aim to prevent suicide should weave together not just the medical and psychological aspects of the issue, but the social, legal, pedagogical, and other dimensions as well. To develop an integrated approach that could provide primary, secondary, and tertiary prevention of suicidal behavior in children, provide the routing of patients, and coordinate actions both between the outpatient link and inpatient specialized care and between different departments, primarily between the Moscow Department of Healthcare and the Department of Education. We analyzed the dynamics of the number of admissions to the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva of Moscow Health Department (Sukhareva Center) with suicidal manifestations in 2019-2022. Organization of the Crisis Care Clinic (Crisis Clinic), which specializes in helping children and adolescents aged 11 to 17 who find themselves in a situation of psychological crisis, have suicidal tendencies, display self-injurious behavior, experience grief, violence, or have suffered abuse. A comprehensive multi-disciplinary approach is identified as the most efficient way to treat and prevent suicidal behavior in children and adolescents. Psychopharmacotherapy is used to influence severe depressive symptomatology, reduce anxiety, moderate sedation, correct behavioral disorders, etc. In addition to medication, comprehensive psychotherapeutic assistance is recommended. The leading therapeutic approaches are cognitive-behavioral, including DBT, and family therapy, with the efforts of therapists concentrated on alleviating post-traumatic stress, depression, and behavioral problems, as well as resolving intrafamily conflicts. The need to remedy severe crisis conditions and their associated psychopathological repercussions (including suicidal and self-harming behavior) calls for coordinated efforts on the part of specialists from different fields of knowledge related to childhood and adolescence. Our analysis of the experience of working with children and adolescents in the Crisis Clinic at the Sukhareva Center shows that there is high demand for such highly specialized institutions and that the basic principles laid down at its creation, urgency, stage, and continuity of care, poly-professionalism with a focus on non-drug treatment methods, orientation towards the patient's family are relevant.