National Center for Fatality Review and Prevention, Michigan Public Health Institute, Okemos, Michigan.
Independent Consultant, Suicide Subject Matter Expert.
Pediatrics. 2024 Nov 1;154(Suppl 3). doi: 10.1542/peds.2024-067043L.
Limited research exists on suicide among children aged 5 to 9 years. The objective of this study was to examine characteristics of suicide in children younger than 10 years.
Data are from the National Fatality Review-Case Reporting System (NFR-CRS) for years 2006 through 2021 for children aged 6 to 9 years who died by suicide. No suicide deaths were reported in NFR-CRS for children aged ≤ 5 years. Descriptive analyses by demographics and circumstances were conducted. A thematic analysis of prevention recommendations made by child death review teams was performed.
From 2006 to 2021, NFR-CRS identified 78 suicide decedents aged 6 to 9 years. The largest share were aged 9 years (72%), male (74%), non-Hispanic Black (42%), and died by hanging (86%) at home (91%). School-related problems (39%), history of child maltreatment (36%), history of mental health services (30%), argument with parents (23%), and familial discord (19%) were common circumstances. Key suicide prevention themes included education for caregivers and school staff, improved behavioral health services, and implementation of school policies and programs.
Results provide a more complete picture of suicide among younger children, improving understanding of their unique characteristics. It is recommended that program planners consider both age-appropriateness and the impacts of social (eg, racism) and structural inequities in their approaches to prevention, encompassing both community and school-based strategies. For pediatricians, results emphasize the importance of lethal means counseling, safety planning, and educating parents and caregivers on the distinct warning signs of suicide for younger children.
针对 5 至 9 岁儿童自杀的研究有限。本研究旨在调查 10 岁以下儿童自杀的特征。
数据来自 2006 年至 2021 年的国家死亡审查-案例报告系统（NFR-CRS），涉及年龄在 6 至 9 岁之间、自杀身亡的儿童。NFR-CRS 未报告年龄≤5 岁的儿童自杀死亡事件。对人口统计学和情况进行描述性分析。对儿童死亡审查小组提出的预防建议进行主题分析。
2006 年至 2021 年，NFR-CRS 确定了 78 名 6 至 9 岁的自杀死者。最大比例为 9 岁（72%）、男性（74%）、非西班牙裔黑人（42%），且在家中（91%）以缢死（86%）的方式自杀。常见的情况包括与学校相关的问题（39%）、儿童虐待史（36%）、精神健康服务史（30%）、与父母争吵（23%）和家庭不和（19%）。关键的预防自杀主题包括对照顾者和学校工作人员的教育、改善行为健康服务以及实施学校政策和计划。
结果提供了关于年幼儿童自杀的更全面的描述，增进了对其独特特征的理解。建议规划人员在其预防措施中考虑到年龄适宜性以及社会（例如，种族主义）和结构性不平等的影响，包括社区和学校为基础的策略。对于儿科医生，结果强调了进行致命手段咨询、安全计划以及对父母和照顾者进行有关年幼儿童自杀明确警示信号的教育的重要性。
