From the Journals

Adolescent suicidal ideation and attempts are on the rise



Annual encounters with suicidal ideation and attempts at children’s hospitals more than doubled during 2008-2015, according to a retrospective analysis by Gregory Plemmons, MD, of Vanderbilt University, Nashville, Tenn., and his coinvestigators.

The researchers also found that suicidal ideation and suicide attempts occurred more often during the spring and fall than in the summer, coinciding with the academic school year, highlighting “the need for further research in the role that schools may play.”

A depressed young woman sits alone KatarzynaBialasiewicz/Thinkstock
Dr. Plemmons and his associates reported that the percentage of hospitalizations for suicidal ideation or attempts rose from 0.66% in 2008 to 1.82% in 2015. They arrived at these figures by analyzing billing data on ED encounters, observation stays, and inpatient hospitalizations at 49 U.S. children’s hospitals included in the Pediatric Health Information System database. Using coding terminology, they identified 115,856 encounters for suicidal ideation or attempts, according to a study published in Pediatrics.

The investigators distinguished three age groups corresponding with commonly accepted definitions of late childhood (5-11 years), early adolescence (12-14 years), and late adolescence (15-17 years). They also looked at differences according to patients’ race/ethnicity and sex, as well as month of the year of the admission.

There were increases in suicidal ideation or attempts across all three age groups, with 50% in late adolescence, 37% in early adolescence, and 13% in late childhood. They also found higher increases among non-Hispanic whites, compared with other races; nearly two-thirds of the suicidal ideation and suicide attempts were among girls.

Only 18.5% of total annual suicidal ideation and suicidal attempts occurred during summer months. Peaks were highest in fall and spring. “We underscore the need for future work to explore the relationship between school and suicidal ideation, recognizing that the role of academics is a complex one, and there may also be other additional influences at play regarding seasonality,” said Dr. Plemmons and his associates.‍

The investigators wrote that, although the reasons for these increasing trends among these age groups are not entirely clear, some have suggested the rise of cyberbullying and social media could be possible factors. This study and its data, though, “have important implications for exploring age- and sex-specific approaches to suicide screening and prevention interventions, as well as further research in examining causal factors for SI [suicidal ideation] and SA [suicide attempts],” they concluded.

SOURCE: Plemmons G et al. Pediatrics. 2018;141(6):e20172426.

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