Study Highlights How Children at High Risk of Suicide May Differ From Adolescents

Although suicide in elementary school–age children (aged 5 to 11) is rare, little is known about the factors precipitating suicide in this age group. A study published today in Pediatrics suggests that children who died by suicide were more likely to have been diagnosed with attention-deficit disorder (ADD) or attention-deficit/hyperactivity disorder (ADHD) than early adolescents (aged 12 to 14) who died by suicide. 

“These findings raise questions about impulsive responding to psychosocial adversity in younger suicide decedents, and they suggest a need for both common and developmentally specific suicide prevention strategies during the elementary school–aged and early adolescent years,” Arielle Sheftall, Ph.D., of Ohio State University and colleagues wrote.

The researchers analyzed suicide data recorded in the National Violent Death Reporting System from 2003 to 2012 in 17 U.S. states and compared individual characteristics and precipitating circumstances of suicide in children aged 5 to 11 to those aged 12 to 14.

About one-third of the children and young adolescents were recorded in the system as having had a current mental health problem, but while depression—a well-known risk factor for suicide—was the most common diagnosis among adolescents (65.6%), young children who died by suicide were most likely to have ADD or ADHD (59.3%).

“Assuming the diagnoses are accurate, this result would suggest that suicide in young children may be more related to impulsive behavior, a hypothesis that warrants further research,” David Fassler, M.D., a child and adolescent psychiatrist and professor at the University of Vermont College of Medicine, told Psychiatric News.

“[S]uch research could have important implications for suicide prevention efforts in childhood and potentially diminish the relevance of traditional strategies focused primarily on identifying and treating depression as a means of mitigating suicide risk,” the study authors wrote.

Other characteristics that were more common in younger children who died by suicide were being male, black, suicide by hanging/strangulation/suffocation, and having died at home.

Fassler noted that because suicide is relatively rare in young children, it can be a challenging population to study. “Despite significant methodological challenges, the study represents an important contribution to the literature on suicide in young children and adolescents,” he said.

For a related story on suicide, see the Psychiatric News article “U.S. Experiences Uptick In Rates of Suicide.”

(Image: iStock/Christopher Futcher)

Parents May Be in Poor Health Prior to a Child's Suicide

Not surprisingly, parents experience considerably more depression, anxiety, marital breakups, and medical illnesses after a child has died by suicide than before this event, a large population study headed by James Bolton, M.D., an assistant professor of psychiatry at the University of Manitoba in Canada, has found. More surprisingly, though, such grieving parents also have mental health and medical illness vulnerability even before the death of their offspring.

For example, when compared before their offspring died with nonbereaved parents who served as control subjects, the parents of offspring who died had higher rates of depression and anxiety and three times more alcohol abuse or dependence than the latter did. And when they were compared before the death of their child with parents who would later lose a child to motor vehicle accidents rather than suicide, they had higher rates of cardiovascular disease, emphysema, and diabetes.

"These markers of poor health," Bolton and colleagues said in JAMA Psychiatry, "may be explained by factors associated with both mental and physical disorders, such as tobacco use, low levels of exercise, adverse childhood experiences, or poverty. Evidence for the latter is demonstrated by higher rates of low income when comparing suicide-bereaved parents with both nonbereaved controls and motor vehicle accident-bereaved parents...."

If mothers lose a child to an unnatural cause of death, such as suicide, it can also increase their own risk of dying prematurely, another study has found. See details of that study in Psychiatric News.

(Image: Renee Schmidt/Shutterstock.com)