Completed Suicide in Childhood

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Suicide in children and young adolescents up to 14 years of age has increased in many countries, warranting research and clinical awareness. International reported suicide rates per 100,000 in this young population vary between 3.1 and 0 (mean rate worldwide, approximately 0.6/100.000; male–female ratio, 2:1). Suicide occurs only in vulnerable children; this vulnerability begins with parental mood disorder and impulsive aggression, and family history of suicide. Childhood affective and disruptive disorders and abuse are the most often reported psychiatric risk factors. Suicide becomes increasingly common after puberty, most probably because of pubertal onset of depression and substance abuse, which substantially aggravate suicide risk. Biologic findings are scarce; however, serotonergic dysfunction is assumed. The most common precipitants are school and family problems and may include actual/anticipated transitions in these environments. Suicides in children and young adolescents up to 14 years of age often follow a brief period of stress. Cognitive immaturity/misjudgment, age-related impulsivity, and availability of suicide methods play an important role. Psychologic autopsy studies that focus on suicides in this age group are needed.

Section snippets

Literature review

Only a few studies investigated suicides in the population aged 14 years and younger, either as a separate population or as a subsample of a larger study (Table 1). Available studies included investigations of available records on suicide (eg, coroner, educational, medical, psychiatric, social service) (n = 4) [4], [5], [12], [13], epidemiologic studies of suicide trends in childhood and early adolescence (n = 4) [14], [15], [16], [17], and a few medical autopsy studies that investigated

Age and Gender

Suicide before puberty is rare, most probably because depression and substance abuse before puberty are also rare [24]. Suicides in the group aged 14 years and younger occur predominantly among 13- to 14-year-olds [26] and are more common among boys [16]. The most recent World Health Organization (WHO) [27] suicide statistics on the population aged 14 years and younger (Table 2) show that the mean suicide rate per 100,000 was 0.59/100,000 (range 3.1–0). The mean male suicide rate was

Summary

Completed suicide in childhood is associated with an extensive personal and social morbidity [9]. An interplay of psychiatric factors (ie, depression), behavioral components (ie, impulsivity), cognitive immaturity, and environmental–contextual factors (ie, family problems) seems to have an important role in suicides among the youngest population [3], [7], [23]. Public psychoeducation [89], psychoeducation of gate-keepers [26], and additional training for pediatricians and general practitioners

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