Suicidal ideation and non-fatal suicide attempts in children aged 10-16 years: intrafamilial psychosocial and clinical factors - abstract

ABSTRACT

Childhood suicide is a newly emerging Caribbean problem. This report draws attention to possible risk factors and some trends which should be monitored. Suicidal ideation was identified in the records of 29 children who attended the Child Guidance Clinic, Kingston, Jamaica for a 2-year period between 1987 and 1989. Of these, 12 (41 per cent) actually made a minimum of 24 suicide attempts. The overall M F ratio was 1 1.6; 2 1 in 10-12 year olds but 1 1.8 in those aged 12-15 years. Boys under 12 years demonstrated repetition of attempts and selection of potentially lethal methods, viz., hanging, jumping from heights, drug overdosage, drowning and stabbing. There were no evident differences between those attempting and those contemplating suicide. By Diagnostic and Statistical Manual III-R (DSM-III-R) criteria, major depressive episodes occurred in about one-third. In the remaining two-thirds, co-morbidity of disorders was prominent, i.e., dysthymic features occurred with or without Conduct Disorder oppositional Defiant Disorder or incomplete forms of these. Physically, abused children displayed angry (aggressive) features more frequently than depressive features. Multiple "service" to "extreme" psychosocial stressors of "enduring" and/or "acute" type were identified, using DSM-III-R criteria poor mother-child relationship (over 90 per cent), child abuse (79 per cent), prolonged parental conflict (66 per cent), early separation experiences (average of 2 per child) and chronic illness (28 per cent). The most common triggering event was an episode of physical and/or verbal abuse in boys and sexual and/or verbal abuse in girls. There may be a complex interplay between the individual, the effects of anger and sadness, and intrafamilial stressors (AU)