Risk Factors for Suicidal Behavior in Children and Adolescents
Type | Examples |
|---|---|
Psychiatric disorders and physical disorders that affect the brain | Mood disorders* (eg, schizophrenia, depressive disorders) Substance use, particularly alcohol and THC† and/or substance use in adolescents Aggressive, impulsive tendencies (conduct disorder) Previous suicide attempts Posttraumatic stress disorder (PTSD) Anxiety disorders |
Family history | Family history of suicidal behavior Increased rates of suicide in adults Parental opioid use‡ Mother with a mood disorder Father with a history of trouble with the police Poor communication with parents |
Psychosocial factors | Recent disciplinary action§ (most commonly, school suspension) Interpersonal loss (loss of a girlfriend or boyfriend, especially in boys; separation from parents) Difficulties in school Social isolation (particularly not working or going to college) Minority in upwardly mobile home Victim of bullying Media reports of suicide (copycat suicide) Sexual/gender minority status |
Environmental factors | Easy access to lethal methods (eg, guns) Barriers to and/or stigma associated with accessing mental health services |
Medications | a b Selective serotonin reuptake inhibitorsc, d d Benzodiazepinesd |
* Mood disorders are present in more than one half of suicidal adolescents. | |
† Gobbi G, Atkin T, Zytynski, et al: Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: A systematic review and meta-analysis. JAMA Psychiatry 76(4):426-434, 2019. doi: 10.1001/jamapsychiatry.2018.4500. | |
‡ Turecki G, Brent DA, Gunnell D, et al: Suicide and suicide risk. Nat Rev Dis Primers 5(1):74, 2019. doi: 10.1038/s41572-019-0121-0. | |
§ Almost half of completed suicides occur after recent disciplinary action. ¶Bremner JD, Shearer K, McCaffery: Retinoic acid and affective disorders: The evidence for an association. J Clin Psychiatry 73(1):37-50, 2012. aBenard B, Bastein V, Vinet B, et alEur Respir J 50(2):1700148. doi: 10.1183/13993003.00148-2017. bMolero Y, Larsson H, D'Onofrio B, et al: Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: Population based cohort study in Sweden. BMJ Clin Res 365:12147, 2019. doi: 10.1136/bmj.l2147. cGibbons RD, Brown CH, Hur K, et al: Early evidence on the effects of regulators' suicidality warnings on SSRI prescriptions and suicide in children and adolescents. Am J Psychiatry 164(9);1356-1363, 2007. doi: 10.1176/appi.ajp.2007.07030454. dGibbons R, Hur K, Lavigne J, et al: Medications and suicide: High dimensional empirical Bayes screening (iDeas). Harvard Data Sci Rev 1.2 2019 (revised 2020). doi: 10.1162/99608f92.6fdaa9d | |