Suicide in elementary school–aged children is not well studied, despite a recent increase in the suicide rate among US black children. The objectives of this study were to describe characteristics and precipitating circumstances of suicide in elementary school–aged children relative to early adolescent decedents and identify potential within-group racial differences.
We analyzed National Violent Death Reporting System (NVDRS) surveillance data capturing suicide deaths from 2003 to 2012 for 17 US states. Participants included all suicide decedents aged 5 to 14 years (N = 693). Age group comparisons (5–11 years and 12–14 years) were conducted by using the χ2 test or Fisher’s exact test, as appropriate.
Compared with early adolescents who died by suicide, children who died by suicide were more commonly male, black, died by hanging/strangulation/suffocation, and died at home. Children who died by suicide more often experienced relationship problems with family members/friends (60.3% vs 46.0%; P = .02) and less often experienced boyfriend/girlfriend problems (0% vs 16.0%; P < .001) or left a suicide note (7.7% vs 30.2%; P < .001). Among suicide decedents with known mental health problems (n = 210), childhood decedents more often experienced attention-deficit disorder with or without hyperactivity (59.3% vs 29.0%; P = .002) and less often experienced depression/dysthymia (33.3% vs 65.6%; P = .001) compared with early adolescent decedents.
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. Further research should investigate factors associated with the recent increase in suicide rates among black children.
I read about this study in the NYTimes and it frustrates me that the most critical information is apparently missing from this study. That is, what medications were these children on? Some psychoactive drugs are known to cause suicidal tendencies in young people, perhaps also true for ADHD medications and extreme cycles of side effects for both/either.
I just found out last week my smart, beautiful 11 year old nephew, on ADHD drugs since the age of 5, is now suicidal. Horrifying as this is, I'm not surprised as I've witnessed hellish scenes of out-of-control behavior at the end of the day, then inability to get up in the morning, both being, his mother said, effects of his medication. You see it in his face.......this child is in torment!
It is preposterously unethical that pediatricians are encouraged to stick kids on drugs before all other options are explored, like behavioral and/or diet modifications. Children are not guinea pigs for the pharmaceutical industry! This study, by leaving out the critical quotient of medications, actually does the entire issue a disfavor, worse yet, fails these tragically at-risk children. I'm sure it cost a lot of money, but what did it accomplish?
St. Louis, Mo
Gwyn Wahlmann