Children as young as five may have the tendency to commit suicide, say researchers who found characteristics and circumstances that may be more prominent in children who die by suicide.
It is the first study to exclusively focus on precipitating circumstances of suicide in children and early adolescents, defined as ages 5 to 14.
"Children who died by suicide were more likely to have relationship problems with family members or friends whereas early adolescents were more likely to have boyfriend or girlfriend relationship problems," said Arielle Sheftall, postdoctoral research fellow at the Nationwide Children's Hospital in the US.
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Researchers used the US National Violent Death Reporting System (NVDRS) and analyses suicide deaths from 2003 to 2012 in 17 different states, segregating them by age group.
"We also found that 29 per cent of children and early adolescents disclosed their intention for suicide to someone prior to their death," added Sheftall.
The study highlights the importance of educating pediatricians, primary health care providers, school personnel and families on how to recognise the warning signs of suicide and what steps to take when suicidal intent is disclosed.
"These warning signs include a child making suicidal statements, being unhappy for an extended period, withdrawing from friends or school activities or being increasingly aggressive or irritable," said Sheftall.
Research indicates that the use of suicide risk screening tools by pediatricians increases the detection of suicide risk in youth 400 per cent without overburdening clinical care.
Not only do pediatricians potentially see at-risk children on a regular basis, early detection allows the healthcare providers an opportunity to alert parents of potential risks and increases the likelihood of a child receiving mental health services in a timely fashion.
"Although suicide is extremely rare in elementary school-aged children, parents should be aware that children can and sometimes do think about suicide," said Jeff Bridge, from Nationwide Children's Hospital in the US.
"It is important to ask children directly about suicide if there is a safety concern. Research has refuted the notion that asking children directly about suicide will trigger suicidal thinking or behaviour," said Bridge.
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