Wednesday, March 28, 2018

Irritability in Childhood May Point to Adolescents at Greater Risk of Suicide

Children who display high levels of depressive/anxious mood symptoms and irritability appear to be at a greater risk of suicide during adolescence, according to a study published today in JAMA Psychiatry.

The findings suggest that “childhood irritability should be considered when assessing adolescent suicidal risk, especially among those presenting with symptoms of high depressive/anxious mood,” wrote Massimiliano Orri, Ph.D., of McGill University and colleagues.

To investigate the association of childhood irritability and depressive/anxious mood with adolescent suicidality, Orri and colleagues pulled data from the Québec Longitudinal Study of Child Development (QLSCD). The study included infants born in Québec in 1997 and 1998 who were assessed annually during childhood and biannually during adolescence through age 17.

The QLSCD dataset included evaluations by school teachers of depressive/anxious mood and irritability in the children at 6, 7, 8, 10, and 12 years. Teachers were asked to rate the children on multiple symptoms of depressive/anxious mood (including crying and worrying) and irritability (including temper tantrums and aggressive reactions when teased or something was taken away). At ages 13, 15, and 17, the youth were asked about whether they had ever seriously thought about attempting suicide and, if so, how many attempts they had made.

Of the 1,430 children who were followed up to age 17, 172 (12.0%) adolescents reported suicidal ideation or suicide attempt, 90 (6.3%) reported serious suicidal ideation, and 82 (5.7%) reported suicide attempt.

Children who were categorized as having high irritability and high depressive/anxious mood reported higher rates of suicidality (25 of 152, or 16.4%) as adolescents compared with children with the lowest symptom levels (91 of 831, or 11.0%). Children with high irritability and high depressive/anxious mood were twice as likely to report serious suicidal ideation and/or to attempt suicide during adolescence compared with those with low irritability and low depressive/anxious mood. Girls categorized as having high irritability and high depressive/anxious mood had a higher risk of suicidality (odds ratio, 3.07) than boys (odds ratio, 2.13).

“Manifestations of irritability during childhood are associated with a significant risk for suicidal behaviors during adolescence,” Orri and colleagues wrote. “This risk was especially high when high levels of irritability were accompanied by high levels of depressive/anxious mood and particularly for girls.”

For related information on suicide, see the Psychiatric News article “Impulsivity May Be Strong Contributor to Childhood Suicides.”

(Image: iStock/MmeEmil)


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