Peyre Hugo, Hoertel Nicolas, Stordeur Coline, Lebeau Gaële, Blanco Carlos, McMahon Kibby, Basmaci Romain, Lemogne Cédric, Limosin Frédéric, Delorme Richard
Département d'Etudes Cognitives, Ecole Normale Supérieure, 29 rue d'Ulm, 75005 Paris, France.
Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France.
J Clin Psychiatry. 2017 Jun;78(6):e622-e630. doi: 10.4088/JCP.16m10876.
To investigate whether risk factors for suicide attempts differ in children and adolescents and to categorize adulthood mental health outcomes of child and adolescent suicide attempters in the general population.
Using a large (N = 34,653), nationally representative US adult sample, the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, we examined whether individuals who first attempted suicide during childhood (under the age of 13 years) differ from those who first attempted suicide during adolescence (13 through 17 years) in (1) contributing factors for first suicide attempt, including mental disorders and traumatic experiences that occurred before the first suicide attempt, parental history of mental disorders, and family poverty and (2) adulthood mental health outcomes, including lifetime and current prevalence of DSM-IV psychiatric disorders and quality of life measures.
Suicide attempts during childhood (n = 104) were more strongly related to childhood maltreatment, while suicide attempts during adolescence (n = 415) were more strongly associated with major depressive episode. Compared to first suicide attempts during adolescence, first attempts during childhood were associated with increased risk for multiple suicide attempts (61.3% vs 32.6%), several psychiatric disorders (mania, hypomania, and panic disorder), and poorer social functioning during adulthood (all P values < .05).
Suicide attempts in children and adolescents substantially differ in contributing factors and adulthood mental health outcomes. Preventing childhood maltreatment and early intervention for psychiatric disorders may have broad benefits to reduce not only the suffering of these children and adolescents, but also the burden of suicide.
探讨儿童和青少年自杀未遂的危险因素是否存在差异，并对普通人群中儿童和青少年自杀未遂者的成年期心理健康结局进行分类。
利用一个规模较大（N = 34,653）、具有全国代表性的美国成年人样本——2004 - 2005年全国酒精及相关疾病流行病学调查，我们研究了在（1）首次自杀未遂的促成因素方面，包括首次自杀未遂前出现的精神障碍和创伤经历、父母的精神障碍病史以及家庭贫困，以及（2）成年期心理健康结局方面，包括《精神疾病诊断与统计手册》第四版（DSM-IV）精神障碍的终生患病率和当前患病率以及生活质量指标，在童年期（13岁以下）首次自杀未遂的个体与在青少年期（13至17岁）首次自杀未遂的个体是否存在差异。
童年期自杀未遂（n = 104）与童年期虐待的关联更强，而青少年期自杀未遂（n = 415）与重度抑郁发作的关联更强。与青少年期首次自杀未遂相比，童年期首次自杀未遂与多次自杀未遂风险增加（61.3%对32.6%）、几种精神障碍（躁狂症、轻躁狂症和惊恐障碍）以及成年期较差的社会功能相关（所有P值 < 0.05）。
儿童和青少年自杀未遂在促成因素和成年期心理健康结局方面存在显著差异。预防童年期虐待以及对精神障碍进行早期干预可能不仅对减轻这些儿童和青少年的痛苦有益，而且对减轻自杀负担也有广泛益处。
