Prevalence and Correlates of Suicide and Nonsuicidal Self-injury in Children: A Systematic Review and Meta-analysis.

dc.contributor.author

Liu, Richard T

dc.contributor.author

Walsh, Rachel FL

dc.contributor.author

Sheehan, Ana E

dc.contributor.author

Cheek, Shayna M

dc.contributor.author

Sanzari, Christina M

dc.date.accessioned

2023-09-14T12:48:12Z

dc.date.available

2023-09-14T12:48:12Z

dc.date.issued

2022-07

dc.date.updated

2023-09-14T12:48:11Z

dc.description.abstract

Importance

Considerably less is known about self-injurious thoughts and behaviors (SITBs) in preadolescence than older age groups, owing partly to the common view that young children are incapable of suicidal thoughts. Yet, preadolescent suicide has increased in recent years and is now the fifth leading cause of death in this age group, leading the National Institute of Mental Health to identify it as a priority for research and intervention.

Objective

To assess prevalence estimates of preadolescent SITBs, identify correlates of these outcomes, and conduct head-to-head comparisons of preadolescent and adolescent SITBs in terms of associated characteristics.

Data sources

MEDLINE, PsycINFO, and Embase were systematically searched from inception through December 23, 2021, for studies on the prevalence and correlates of preadolescent SITBs. The search was restricted to English language publications and peer-reviewed journals.

Study selection

Two reviewers independently identified studies providing data on prevalence and correlates of preadolescent SITBs.

Data extraction and synthesis

Two reviewers independently extracted data from each study, and the Joanna Briggs Institute Checklist for Prevalence Studies was used to assess study quality. Pooled prevalence and Cohen d were derived from random-effects meta-analyses. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed.

Main outcomes and measures

Prevalence and correlates of suicidal ideation, suicide attempts, suicide deaths, and nonsuicidal self-injury among preadolescents.

Results

Fifty-eight studies with 626 486 590 individuals were included. Lifetime prevalence of suicide in the general population was 0.79 per 1 million children. Prevalence for lifetime suicidal thoughts, suicide attempts, and nonsuicidal self-injury among preadolescents were 15.1%, 2.6%, and 6.2%, respectively, in community samples. These data suggest that approximately 17.0% of preadolescents with suicidal ideation transition to attempting suicide. Across several analyses, male individuals appear more likely to have SITBs in preadolescence than adolescence. Correlate data were modest for SITBs other than suicidal ideation, but among specific disorders, attention-deficit/hyperactivity disorder (suicidal ideation: d = 0.54 [95% CI, 0.34-0.75]) and depression (suicidal ideation: d = 0.90 [95% CI, 0.71-1.09]; suicide attempts: d = 0.47 [95% CI, 0.26-0.68]) emerged as the strongest correlates. Among interpersonal factors, child maltreatment (suicidal ideation: d = 2.62 [95% CI, 1.56-3.67]) and parental support (suicidal ideation: d = -0.34 [95% CI, -0.46 to -0.22]) yielded the largest effect sizes.

Conclusions and relevance

In this systematic review anda meta-analysis, although preadolescent suicide deaths were rare, other SITB types occur with concerning frequency. Male individuals were at greater risk for SITBs in preadolescence relative to adolescence. Attention-deficit/hyperactivity disorder, child maltreatment, and parental support were especially relevant to suicidal ideation, as well as depression for suicidal thoughts and behaviors, in this age group. Further study, especially of SITBs other than suicidal ideation, is needed.
dc.identifier

2792812

dc.identifier.issn

2168-622X

dc.identifier.issn

2168-6238

dc.identifier.uri

https://hdl.handle.net/10161/29001

dc.language

eng

dc.publisher

American Medical Association (AMA)

dc.relation.ispartof

JAMA psychiatry

dc.relation.isversionof

10.1001/jamapsychiatry.2022.1256

dc.subject

Humans

dc.subject

Prevalence

dc.subject

Self-Injurious Behavior

dc.subject

Suicide, Attempted

dc.subject

Child Abuse

dc.subject

Adolescent

dc.subject

Aged

dc.subject

Child

dc.subject

Child, Preschool

dc.subject

Male

dc.subject

Suicidal Ideation

dc.title

Prevalence and Correlates of Suicide and Nonsuicidal Self-injury in Children: A Systematic Review and Meta-analysis.

dc.type

Journal article

pubs.begin-page

718

pubs.end-page

726

pubs.issue

7

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Psychiatry & Behavioral Sciences

pubs.organisational-group

Psychiatry, Child & Family Mental Health & Community Psychiatry

pubs.publication-status

Published

pubs.volume

79

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
jamapsychiatry_liu_2022_oi_220031_1655850840.02026.pdf
Size:
263.85 KB
Format:
Adobe Portable Document Format
Description:
Published version