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Greydanus DE, Nazeer A, Qayyum Z, Patel DR, Rausch R, Hoang LN, Miller C, Chahin S, Apple RW, Saha G, Prasad Rao G, Javed A. Pediatric suicide: Review of a preventable tragedy. Dis Mon 2024; 70:101725. [PMID: 38480023 DOI: 10.1016/j.disamonth.2024.101725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Concepts of suicide are explored in this issue with a focus on suicide in children and adolescents. The epidemiology of pediatric suicide in the United States is reviewed; also, risk and protective factors, as well as prevention strategies, are discussed. Suicide in the pediatric athlete and the potential protective effect of exercise are examined. In addition, this analysis addresses the beneficial role of psychological management as well as current research on pharmacologic treatment and brain stimulation procedures as part of comprehensive pediatric suicide prevention. Though death by suicide in pediatric persons has been and remains a tragic phenomenon, there is much that clinicians, other healthcare professionals, and society itself can accomplish in the prevention of pediatric suicide as well as the management of suicidality in our children and adolescents.
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Affiliation(s)
- Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Ahsan Nazeer
- Division of Child and Adolescent Psychiatry, Sidra Medicine/Weill Cornell Medicine, Doha, Qatar
| | - Zheala Qayyum
- Harvard Medical School, Boston, Massachusetts, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Rebecca Rausch
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Linh-Nhu Hoang
- Western Michigan University, Kalamazoo, MI, United States
| | - Caroline Miller
- Fielding Graduate University, Santa Barbara, CA, United States
| | - Summer Chahin
- Mott Children's Hospital, University of Michigan, Ann Arbor, MI, United States
| | - Roger W Apple
- Division of Pediatric Psychology, Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Gautam Saha
- Immediate Past President of the SAARC (South Asian Association for Regional Cooperation) Psychiatric Federation (SPF), India
| | - G Prasad Rao
- President, Asian Federation of Psychiatric Association (AFPA), India
| | - Afzal Javed
- Chairman Pakistan Psychiatric Research Centre, Immediate Past President of the World Psychiatric Association (WPA), Pakistan
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Stein B, Hoeft F, Richter CG. Stress, resilience, and emotional well-being in children and adolescents with specific learning disabilities. Curr Opin Behav Sci 2024; 58:101410. [PMID: 39157263 PMCID: PMC11326484 DOI: 10.1016/j.cobeha.2024.101410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
This article reviews the prevalence of stress and explores resilience factors in children and adolescents with specific learning disabilities (SLDs). We show that the increased stress and emotional challenges faced by this group are likely due to societal pressures and stigma. Recent findings on neuroendocrine changes in this population are discussed, suggesting a predisposition to psychiatric disorders. This review advocates for a societal shift towards the neurodiversity paradigm, which recognizes SLDs as natural variations in brain function, emphasizing individual strengths and promoting a more inclusive approach that values cognitive diversity. Such advocacy is likely important to combat stress and stigma in those with SLDs. This article also reviews recent work identifying resilience-promoting factors, such as perception of self and peer/teacher relationships, for enhancing emotional well-being and mental health for children and adolescents with SLD.
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Affiliation(s)
- Brianna Stein
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd., Birmingham, AL, 35233, USA
| | - Fumiko Hoeft
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
- Department of Psychiatry and Behavioral Sciences, and Weill Institute for Neurosciences, University of California San Francisco, CA, 675 18 St., San Francisco, CA, 94143, USA
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Caroline G. Richter
- Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd., Birmingham, AL, 35233, USA
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Pears KC, Tiberio SS, Kim HK. Reducing Suicidal Ideation in Preadolescents With a History of Foster Care by Promoting School Readiness in Early Childhood. CHILD MALTREATMENT 2024; 29:165-175. [PMID: 35835729 DOI: 10.1177/10775595221115209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Preadolescents with a history of foster care placement report suicidal ideation (SI) at higher rates than their peers, which increases their risk for suicide attempts in adolescence. Despite these increased risks, few interventions have been shown to reduce SI in these youth. This study examined the main and mediated long-term effects of a program to increase school readiness in children in foster care at age 5 years on SI when the children were ages 9-11 years, 4-6 years after the intervention ended. Children who received the intervention were less likely to report SI, although the difference did not reach statistical significance. The intervention reduced SI indirectly through its positive effect on children's self-esteem at age 9 years. Implications for programming to reduce SI and subsequent suicide attempts in youth with a history of foster care are discussed.
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Affiliation(s)
- Katherine C Pears
- Oregon Social Learning Center, Eugene, OR, USA
- OSLC Developments, Inc, Eugene, OR, USA
| | | | - Hyoun K Kim
- Department of Child & Family Studies, Yonsei University, Seodaemun-gu, Korea
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Ortin-Peralta A, Sheftall AH, Osborn A, Miranda R. Severity and Transition of Suicidal Behaviors in Childhood: Sex, Racial, and Ethnic Differences in the Adolescent Brain Cognitive Development (ABCD) Study. J Adolesc Health 2023; 73:724-730. [PMID: 37389520 PMCID: PMC10527698 DOI: 10.1016/j.jadohealth.2023.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/03/2023] [Accepted: 05/25/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE To examine the prevalence, incidence, and transitions of suicide ideation and attempts and sex and racial/ethnic differences among children enrolled in three yearly assessments of the Adolescent Brain Cognitive Development Study. The forms of suicidal ideation (SI) (no SI, passive, nonspecific active, and active) among those who attempted suicide were also described. METHODS A subsample of 9,923 children (9-10 years old at baseline, 48.6% female) completed the KSADS-5 questions about suicide ideation and attempts in three yearly assessment (83.5% of baseline sample). RESULTS Almost 18% of the children reported suicidal ideation and 2.2% a suicide attempt at one of the three assessments. Passive (6.9%) and nonspecific active (6.4%) were the most frequent forms of suicidal ideation reported. Of the children with suicidal ideation at baseline, 5.9% first attempted suicide in the two subsequent years. Boys (vs. girls) reported more suicidal ideation at baseline. Black children (vs. White and Hispanic/Latinx) and girls (vs. boys) were more likely to start thinking about suicide over time. Black children (vs. White) reported more suicide attempts at baseline and across assessments. More than half of the children who attempted suicide at any assessment reported nonspecific active suicidal ideation (desire to kill oneself without plan/intent/method) as the most severe form of ideation. DISCUSSION Findings suggest a high prevalence of suicidal ideation among children in the US. When conducting risk assessments, clinicians should consider both active and nonspecific active suicidal ideation. Early intervention with children who are thinking about suicide may reduce their risk for attempting suicide.
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Affiliation(s)
- Ana Ortin-Peralta
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York.
| | - Arielle H Sheftall
- Department of Psychiatry, The University of Rochester Medical Center, Rochester, New York
| | - Abigail Osborn
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - Regina Miranda
- Department of Psychology, Hunter College, City University of New York, New York, New York; The Graduate Center, City University of New York, New York, New York
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Ilia S, Sakapeti E, Briassoulis P, Gerostergios G, Vgontzas A, Briassoulis G. Suicidality Prevalence in a Pediatric Psychiatric Clinic: Relation to Social and Environmental Risk Factors. CHILDREN 2023; 10:children10030558. [PMID: 36980115 PMCID: PMC10047874 DOI: 10.3390/children10030558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Suicidality is a growing public health problem in children and adolescents. The aim of this retrospective data analysis study was to estimate the prevalence of suicidality in pediatric patients admitted to an academic Pediatric Psychiatric Clinic (PPC) and to analyze social and environmental risk factors associated with suicide. Suicidal ideation was assessed by the Self-Injurious Thoughts and Behaviors Interview. Using established psychometric scales, social and stressful events were analyzed. During the four-year study, 249 episodes of care were experienced by 152 individuals (mean age 15.2 ± 2 years, girls/boys 107/45). Twenty-eight patients (11.2%) were admitted from the Pediatric Intensive Care Unit and the Department of Pediatrics, 162 (65.1%) from the Pediatric Emergency Department, and 59 (23.7%) from other Hospitals (p = 0.003). A significant longitudinal increase in admissions to PPC, with increasing trends of suicidal ideation, suicide attempts, and suicidality, was recorded. Suicidal behavior, bullying, internet addiction, friends quarreling, and family problems were risk factors for suicide attempts and suicidality. Our results have implications for prevention programs, highlighting an increasing need for care for suicide attempts and suicidal ideation, related to specific stressful events and contextual socio-environmental status.
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Affiliation(s)
- Stavroula Ilia
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Evangelia Sakapeti
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Panagiotis Briassoulis
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
- Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - George Gerostergios
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Alexandros Vgontzas
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - George Briassoulis
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
- Correspondence: ; Tel.: +30-2810-394675
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Prevalence of suicidal ideation and self-harm behaviours in children aged 12 years and younger: a systematic review and meta-analysis. Lancet Psychiatry 2022; 9:703-714. [PMID: 35907406 DOI: 10.1016/s2215-0366(22)00193-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Suicide in children is a pressing public health concern. The increasing number of deaths by suicide and emergency visits for suicidal ideation and self-harm in children might not be fully representative; it is likely that many more children are in distress but do not seek out help. We conducted a systematic review and meta-analysis of existing studies to quantify the prevalence of suicidal ideation and self-harm behaviours among children in the community aged 12 years and younger. METHODS In this systematic review and meta-analysis, we searched PsycINFO, MEDLINE, and Web of Science via OVID from database inception to Feb 28, 2022, for articles published in French or English that reported estimates of prevalence of suicidal ideation (including suicide planning) and self-harm behaviours (namely, self-harm, suicide attempts, and non-suicidal self-injury) in children aged 12 years and younger. Reference lists were also searched; case studies, qualitative studies, and health-care visit studies were excluded. The outcomes were suicidal ideation, suicide plan or attempts, and self-harm. We used a random-effects model to calculate the overall pooled prevalence of suicidal ideation and self-harm behaviours for all timeframes combined and for ever versus the past 12 months for suicidal ideation. We used the Joanna Briggs Institute Critical Appraisal tool to evaluate the risk of bias in each study. This study is registered with PROSPERO, CRD42020179041. FINDINGS 28 articles, encompassing 30 studies overall, met the inclusion criteria, aggregating findings from 98 044 children (of whom 46 980 [50·5%] were girls and 46 136 [49·5%] were boys; six articles did not report sex or gender) aged 6-12 years. The pooled prevalence estimate was 7·5% (95% CI 5·9-9·6) for suicidal ideation from 28 studies and 2·2% (2·0-2·5) for suicide planning from three studies. The pooled prevalence was 1·4% (0·4-4·7) for self-harm from four studies, 1·3% (1·0-1·9) for suicide attempt from six studies, and 21·9% (6·2-54·5) for non-suicidal self-injury from two studies. The prevalence of suicidal ideation was higher in studies that included child-reported outcomes (10·9% [95% CI 8·1-14·5] for child only and 10·4% [6·8-15·5] for child and parent combined) than for parent-only reported outcomes (4·7% [3·4-6·6]; p=0·0004). The prevalence of suicidal ideation and self-harm behaviours was similar in boys and girls (suicidal ideation, 7·9% [95% CI 5·2-12·0] for boys vs 6·4% [3·7-10·7] for girls; self-harm behaviours, 3·5% [1·6-7·2] for boys vs 3·0% [1·4-6·4%] for girls). Detailed ethnicity data were not available. High heterogeneity was identified across estimates (I2>90%), which was not well explained by the characteristics of the studies. INTERPRETATION A high number of children in the general population can experience suicidal ideation and self-harm behaviours, thus underlining the need for more research on childhood suicide, including developmentally appropriate preventive strategies, such as youth-nominated support teams or dialectical behavioural therapy. FUNDING Canada Research Chair in Youth Mental Health and Suicide Prevention.
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