Suicide in children and adolescents

Suicide in children and adolescents has long been a matter of great concern to modern society, particularly for clinicians who deal with mental health problems of children and adolescents. For instance, in 1910 the Vienna Psychoanalytic Society with Sigmund Freud among the attending experts held a conference, dealing with what was perceived to be a growing epidemic of youth suicide (Greydanus & Calles, 2007). At the beginning of the 21st century, suicide and suicide attempts by children and adolescents continue to be a major public health problem, and topical research and surveys have clearly highlighted suicide as one of the commonest causes of death among young people.

Epidemiology of suicide

Suicide is one of the major causes of death worldwide and suicide rates vary according to region, sex, age, time, ethnic origin, and, probably, practices of death registration. Most people who die by suicide have psychiatric disorders, notably mood, substance-related, anxiety, psychotic, and personality disorders, with high rates of comorbidity.

Suicidal cognitions and behaviours can occur both independently and together. Risk of onset of suicidal ideation increases rapidly during adolescence and young adulthood, and then stabilizes in early midlife. The prevalence rates in adolescents cross-nationally are reported to be 19.8.0% for suicide ideation, and 3.1%.8% for suicide attempts (Nock et al, 2008a). The incidence of suicide attempts reaches a peak during the mid-adolescent years, and at that age mortality from suicide, which increases steadily through the teen years, is the third leading cause of death.

Suicide in childhood and early adolescence is rare. However, in adolescents and young adulthood suicide rates increase to mean worldwide annual rates of suicide among 5 year olds of 0.5 per 100,000 for females and 0.9 per 100,000 for males, and for 15- year olds 12.0 per 100,000 for females and 14.2 per 100,000 for males, respectively (Pelkonen & Marttunen, 2003). Males often outnumber females in worldwide youth suicide statistics, although this is variable between different countries.

Suicide rates in elderly people have fallen in many countries, whereas those in young people have risen (Hawton & van Heeringen, 2009).

Risk factors for suicide

Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social and cultural factors. For instance, the relationship between psychiatric disorders and adolescent suicide is well established. Mood disorders, substance abuse and prior suicide attempts are strongly related with youth suicides (Pelkonen & Marttunen, 2003). The effects of media and congestion are also relevant, with the internet having an important contemporary role, as well as family history of suicidal behaviour, family adversity and upbringing, social alienation, exposure to suicidal behaviour by others and in the media, and availability of means (Hawton et al., 2012; Hawton & van Heeringen, 2009; Pelkonen & Marttunen, 2003).