September 20, 2016

 

ADHD — not depression — is the most common diagnosis for young children between the ages of 5 and 11 who commit suicide, a new study finds.

Children under the age of 12 are often overlooked in conversations about suicide and suicide prevention, but the sobering reality is that a small number of U.S. children between the ages of 5 and 11 kill themselves every year. Now, a new study adds another dimension to the story of suicide’s youngest victims: more of them lived with ADHD than any other mental health diagnosis — even depression.

The study, published September 19 in the journal Pediatrics, looked at 87 children between the ages of 5 and 11 who took their own lives between 2003 and 2012. They were compared with 606 adolescents, between the ages of 12 and 17, who committed suicide in the same period. Data was drawn from the National Violent Death Reporting System (NVDRS), a U.S. database that collects information from coroners, police officers, and death certificates to track violent deaths; all the children hailed from one of 17 states that participate in the NVDRS and allow outside researchers to access the data.

Approximately one-third of the children overall had a documented mental health diagnosis, the researchers noted. In adolescence, children who committed suicide were most likely to be suffering from depression — nearly two-thirds of teens who took their own lives showed depressive symptoms before their deaths. But in children under the age of 12, depression only showed up in a third of the children. An overwhelming majority — more than 60 percent — had ADHD (primarily hyperactive type).

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Recent statistics compiled by the Centers for Disease Control and Prevention (CDC) found a suicide rate of 0.17 per 100,000 for children under the age of 12, while adolescents between the ages of 12 and 17 commit suicide at a rate of 5.18 per 100,000. Suicide prevention strategies for this age group (as well as for adults) have historically focused on identifying and treating depression, the researchers said. But based on the results of this study, a depression-focused strategy might be ineffective for the youngest kids that are at risk.

“Maybe in young children, we need to look at behavioral markers,” said Jeffrey Bridge, the lead author of the paper and an epidemiologist at Nationwide Children’s Hospital in Columbus, Ohio. The results might suggest that suicide among young children is more the result of impulsivity than long-term depression, he said.

Not every suicide expert agreed. Dr. Nancy Rappaport, a child psychiatrist who was not involved in the study, wondered if undiagnosed pediatric bipolar disorder might be the cause. A lot of children with that condition, which is marked by volatile mood swings and debilitating depression, “are often undiagnosed under 12,” she said in an interview with the New York Times. In many cases, she added, these children are mistakenly diagnosed with ADHD.

Regardless, experts agree it’s important to take suicidal thoughts or words seriously — at any age — and say that parents shouldn’t be afraid to talk to their children about what they’re thinking and feeling.

“It’s okay to ask your child, ‘Are you feeling like you don’t want to be around anymore?’” said Jill Harkavy-Friedman, the vice president of research at the American Foundation for Suicide Prevention. “It won’t put the idea in their head, but it opens the door for a conversation.”

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The study identified another disturbing trend: an unusually high rate of suicide among African American children. Thirty-seven percent of the children who killed themselves were black, even though black children only make up 15 percent of the youth population in the U.S. This discovery builds on a 2015 study — conducted by some of the same researchers — that found that while the suicide rate among white youth was dropping, it’s nearly doubled for black children since 1990. ADHD diagnoses are rising for this group, too — leading some researchers to wonder if there could be a connection between rising ADHD diagnoses and rising suicide rates.

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