More Research Needed to Quantify Child Suicide Ideation

There remains a need to better quantify the growing public health problem of suicide ideation and self-harm among pediatrics younger than 12 years.

A team, led by Marie-Claude Geoffroy, PhD, Department of Educational and Counselling Psychology, McGill University, quantified the prevalence of suicidal ideation and self-harm behaviors among pediatric patients aged 12 years and younger.

A Growing Problem

While the numbers of deaths by suicide and emergency visits for suicidal ideation and self-harm is increasing, the numbers might not be fully representative because many more pediatric patients do not seek out help when in distress.

In the systematic review and meta-analysis, the investigators searched various databases from inception to February 28, 2022 for studies reporting estimates of prevalence of suicidal ideation and self-harm behaviors in patients aged 12 years and younger.

The investigators sought outcomes of suicidal ideation, suicide plan or attempts, and self-harm.

The team also calculated the overall pooled prevalence of suicidal ideation and self-harm behaviors for all timeframes combined and forever compared to the past 12 months for suicidal ideation using a random-effects model. The team also used the Joanna Briggs Institute Critical Appraisal tool to evaluate the risk of bias in each study.

The Studies

They identified 30 studies involving 98,044 pediatric patients aged 6-12 years with a pooled prevalent of 7.5% (95% CI, 5.9–9.6) for suicidal ideation from 28 studies and 2.2% (95% CI, 2.0–2.5) for suicide planning from 3 studies. There was also a pooled prevalence of 1.4% (95% CI, 0.4-4.7) for self-harm from 4 studies, 1.3% (95% CI, 1.0-1.9) for suicide attempt from 6 studies, and 21.9% (95% CI, 6.2-54.5) for non-suicidal self-injury from 2 studies.

The prevalence of suicidal was 10.9% in studies that included child-reported outcomes (95% CI, 8.1-14.5) for child only and 10.4% (95% CI, 6.8-15.5) for child and parent combined. This was higher than for studies reporting parent-only outcomes (4.7%; 95% CI, 3.4-6.6; P = 0.0004).

The investigators also found similar prevalence for suicidal ideation and self-harm behaviors for males and females (suicidal ideation, 7·9%; 95% CI, 5.2–12.0 for males vs 6.4%; 95% CI, 3.7–10.7 for females; self-harm behaviors, 3.5%; 95% CI, 1.6–7.2 for males vs 3.0%; 95% CI, 1.4–6.4% for girls).

“A high number of children in the general population can experience suicidal ideation and self-harm behaviors, thus underlining the need for more research on childhood suicide, including developmentally appropriate preventive strategies, such as youth-nominated support teams or dialectical behavioral therapy,” the authors wrote.

The study, “Prevalence of suicidal ideation and self-harm behaviors in children aged 12 years and younger: a systematic review and meta-analysis,” was published online in The Lancet Psychiatry.