Psychosocial Correlates of Suicidal Ideation and Behavior in Adolescents and Preadolescent Children Discharged from an Emergency Department in Israel

Abstract

Objectives

Adolescent suicidal behavior is highly prevalent in pediatric psychiatric emergency departments, and there is a growing occurrence of such behavior among preadolescent children. This study aims to examine the psychosocial factors associated with nonfatal suicidal behaviors in children (<12 years old) and adolescents (aged 12–18), to gain insight into unique and shared characteristics of suicidal behavior across these two age groups.

Method

This study investigates the psychosocial characteristics associated with suicidal ideation and behaviors in an emergency department sample of 183 children and adolescents aged 7–18 years in Israel. Participants completed a diagnostic interview, and self-report and parent-report questionnaires of psychosocial measures. Cross-sectional correlational and regression analyses were used to determine significant correlates of suicidal outcomes within the two age groups.

Results

Among adolescents, females exhibited a higher prevalence of suicidal thoughts and behaviors, while in children, both boys and girls showed similar rates. Depression correlated with suicidal ideation for both adolescents and children. In children, anxiety and conduct symptoms were associated with suicidal behavior, whereas in adolescents, suicidal behavior was associated with depression and anxiety.

Conclusions

The present findings contribute to the growing understanding of factors associated with suicidal thoughts and behaviors among children in comparison to adolescents. These findings underscore the importance of targeting specific risk factors when developing assessment and intervention strategies tailored to the two age groups.

HIGHLIGHTS

• Suicidal thoughts and behaviors were more common in female adolescents, but similar for boys and girls in children.

• Different correlates were found for suicidal behavior in children compared to adolescents.

• This study emphasizes the need for age-specific tailored assessment and intervention.

Keywords:

• Adolescents
• children
• emergency department
• ideation
• suicide attempt

ACKNOWLEDGMENTS

The authors acknowledge the research assistants and clinical staff of the depression clinic at Schneider Children’s Medical Center of Israel for their important contribution to the data collection.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on reasonable request from the corresponding author.

INSTITUTIONAL REVIEW BOARD STATEMENT

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Rabin Medical Center, no. 0313-18, on August 27, 2018.

INFORMED CONSENT STATEMENT

Informed consent was obtained from all subjects involved in the study.

Notes

1 For more information on the instruments please refer to the supplemental file.

Additional information

Funding

This work was supported by the American Foundation for Suicide Prevention grant number YIG-1-016-20 and by Israel’s Ministry of Science and Technology grant number 3-15289. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding sources.

Notes on contributors

Oren Shahnovsky

Oren Shahnovsky, M.A., Nermin Toukhy, Ph.D., and Dana Grisaru Hergas, M.A., Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

Lior Pirogovsky

Lior Pirogovsky, B.A., Shannel Akhavan, M.D., Dana Grisaru Hergas, M.A., Alan Apter, M.D., Liat Haruvi-Catalan, Ph.D., Noa Benaroya-Milshtein, M.D., and Silvana Fennig, M.D., Department of Psychiatry, Schneider Children’s Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Nermin Toukhy

Oren Shahnovsky, M.A., Nermin Toukhy, Ph.D., and Dana Grisaru Hergas, M.A., Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

Shannel Akhavan

Lior Pirogovsky, B.A., Shannel Akhavan, M.D., Dana Grisaru Hergas, M.A., Alan Apter, M.D., Liat Haruvi-Catalan, Ph.D., Noa Benaroya-Milshtein, M.D., and Silvana Fennig, M.D., Department of Psychiatry, Schneider Children’s Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Dana Grisaru Hergas

Oren Shahnovsky, M.A., Nermin Toukhy, Ph.D., and Dana Grisaru Hergas, M.A., Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

Alan Apter

Lior Pirogovsky, B.A., Shannel Akhavan, M.D., Dana Grisaru Hergas, M.A., Alan Apter, M.D., Liat Haruvi-Catalan, Ph.D., Noa Benaroya-Milshtein, M.D., and Silvana Fennig, M.D., Department of Psychiatry, Schneider Children’s Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Liat Haruvi-Catalan

Lior Pirogovsky, B.A., Shannel Akhavan, M.D., Dana Grisaru Hergas, M.A., Alan Apter, M.D., Liat Haruvi-Catalan, Ph.D., Noa Benaroya-Milshtein, M.D., and Silvana Fennig, M.D., Department of Psychiatry, Schneider Children’s Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Noa Benaroya-Milshtein

Lior Pirogovsky, B.A., Shannel Akhavan, M.D., Dana Grisaru Hergas, M.A., Alan Apter, M.D., Liat Haruvi-Catalan, Ph.D., Noa Benaroya-Milshtein, M.D., and Silvana Fennig, M.D., Department of Psychiatry, Schneider Children’s Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Silvana Fennig

Lior Pirogovsky, B.A., Shannel Akhavan, M.D., Dana Grisaru Hergas, M.A., Alan Apter, M.D., Liat Haruvi-Catalan, Ph.D., Noa Benaroya-Milshtein, M.D., and Silvana Fennig, M.D., Department of Psychiatry, Schneider Children’s Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Shira Barzilay

Shira Barzilay, Ph.D., Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.