This Month in Psychopharmacology

Prevalence and Risk Factors for Suicidality in Preadolescent Children

It is estimated that the prevalence of suicide among preadolescent children has tripled over the past ten years; however, suicidality has been somewhat understudied in this population as most studies concentrate on adolescents. In this study, Deville and colleagues provide much-needed research into the actual prevalence of suicide, suicide ideation, and nonsuicidal self-injury (NSSI) as well as factors associated with suicidality and NSSI among 11,814 children (age 9-10 years) from across the United States. The prevalence of suicide, suicidality, and NSSI found in the current study were greater than previous estimates and point out the need for suicide interventions in this young population (Figure 1). While gender and race did not greatly affect the risk for suicidality or self-harm among preadolescent youth, several family/environmental factors (including financial adversity, family conflict, and low parental monitoring) were commonly seen in patients endorsing suicidality or self-harm. Additionally, greater internalizing and externalizing issues as well as family history of depression and suicide were more common among youths with suicidal ideation, suicide attempts, and NSSI. Perhaps most alarming (and most informative for assessing suicide risk among preadolescent children) was the discordance found between caregiver reports of suicidality, suicide attempt, and NSSI and self-reports from children themselves (Figure 2). In essence, the results from this study point to the need for suicide risk assessment that includes careful interview with the preadolescent patient (as well as parental/caregiver informants) and indicates potential strategies addressing family dynamics in order to reduce death by suicide among 9-10 year old children.

Figure 1. Prevalence of Suicidality, Suicide Attempt, and Self-Harm Among Preadolescents

Figure 2. Discordance Between Parent and Child Reports of Self-Harm, Suicidal Ideation, and Suicide Attempt.



Reference:

Deville DC et al. JAMA Network Open 2020;3(2): e1920956. Abstract


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This Month in Psychopharmacology: Child Psychiatry