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 “Although suicide is extremely rare in elementary school-aged
children, a child can and sometimes will think about and even
attempt suicide,” said senior study author Dr. Jeffrey Bridge of
Nationwide Children’s Hospital in Columbus, Ohio.
The findings suggest that suicide prevention efforts may need to
include a focus on behavior even before children appear suicidal,
Bridge added by email.
“This approach has incredible potential to reduce suicide rates in
young people,” Bridge said.
In 17 states from 2003 to 2012, researchers compared 87 suicides in
kids ages 5 to 11 to 606 suicides in adolescents aged 12 to 14.
About one third in each group had a diagnosed mental health problem,
researchers report in the journal Pediatrics.
Roughly 59 percent of the young kids in the study with a mental
health diagnosis had attention deficit disorder, with or without
hyperactivity, compared with 29 percent of the teens.
The pattern was reverse in the teens. Depression accounted for 66
percent of their mental health diagnoses, compared with just 33
percent for the younger children.
Overall, few children and early adolescents had illegal drugs or
alcohol in their systems when they died, the study also found.
However, about 4 percent of the younger kids and 8 percent of the
older children tested positive for opiates, which can include
prescription painkillers such as codeine and hydrocodone (Vicodin)
as well as heroin.
Compared to the teens, the younger suicide victims were more often
male, black, and experiencing relationship problems with friends or
family members. Younger child suicides were also more likely to
happen at home and involve hanging, strangulation or suffocation.
Among the younger suicides, slightly more than 33 percent were
black, compared with about 12 percent of the teens.
One limitation of the study is that it only included 17 states, so
it isn’t a nationally representative snapshot of suicides among
children and teens, the authors note. Researchers also lacked data
on drug and alcohol use and the circumstances preceding suicide in
some cases.
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Even so, the findings suggest that factors contributing to suicide
may be different for younger children than for teens, said Dr.
Benjamin Shain, a researcher at NorthShore University HealthSystem
and the University of Chicago who wasn’t involved in the study.
“Suicide among children may be even more impulsive than it is among
adolescents,” Shain added by email.
Prevention efforts might include teaching children how to regulate
their emotions and solve problems, said Dr. Bernard Biermann, a
psychiatry researcher at the University of Michigan’s C.S. Mott
Children’s Hospital in Ann Arbor.
“When it comes to school-aged children, it is important to recognize
that impulsivity, combined with low frustration tolerance, can be
dangerous,” Biermann, who wasn’t involved in the study, said by
email.
Parents should be alert for behavior problems that may surface at
school or at home, said Dr. Yolanda Evans, a researcher at Seattle
Children’s Hospital who wasn’t involved in the study.
“It may be more beneficial to focus school prevention on improving
family and adult communication around emotions, providing avenues
for impulse control, and encouraging children to speak up about
feelings and teaching parents, teachers, and staff to take any
children seriously if they mention thoughts of suicide,” Evans said
by email.
What happens after school matters, too.
“Engage children in after-school activities if possible, this
exposes them to adults they may learn to trust and confide in,
provides an outlet for hyperactive behaviors, provides distraction
and social connections to peers, too,” Evans added. “Keep an open
line of communication with your kids and if they talk at all about
death and suicide, take it seriously.”
SOURCE: http://bit.ly/2cLBf7d Pediatrics, online September 19, 2016.
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