Characterization of suicidal behavior among children in a depressive episode: Case series study

Introduction: Child suicidal behavior is related to specific childhood variations, constituting risk factors, including predisposing factors, internal factors, and environmental factors.
Objective: To characterize suicidal behavior among children aged 5 to 12 years diagnosed with a depressive episode.

Methods: Fifteen participants, aged 5 to 12, were assessed at a child and adolescent mental health center in Belo Horizonte, state of Minas Gerais, Brazil. All participants had a history of suicide attempt and were in a depressive episode at the time of assessment.
Results: Vulnerabilities related to the children themselves were self-harm, aggression, loss of an important family figure, sexual abuse, sexuality disorders, use of alcohol or other drugs, and illtreatment. Factors of family structure and dynamics found were psychiatric illness in family members, family conflict or violence, abandonment or rejection, history of suicidal behavior in family, parents users of alcohol and other drugs, and separated parents. Factors related to school were bullying, school difficulties/delays, high school performance, bad behavior, physical aggression, school dropout, and aggressiveness. The main methods used in suicide attempts were injury by sharp or blunt objects and
intentional self-poisoning.

Conclusions: Psychiatric comorbidities and a previous history of disturbances in the family and at school are important factors to consider with relation to suicidal behavior by children with depressive episodes.