Screen Children with Autism for Suicide Ideation, Attempts

Article excerpt

AT THE ANNUAL MEETING OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY

SAN FRANCISCO--Suicide attempts or ideation were a problem in 43% of autistic children compared with 14% of depressed nonautistic children and 0.5% of children with neither depression nor autism, in a prospective study of 1,012 children.

Mothers of the children rated 165 items on the Pediatric Behavior Scale from "not at all a problem" to very often a problem." Suicide ideation and attempts were considered a problem if they occurred anywhere from sometimes to very often.

"Because suicide ideation and attempts in autism are significantly higher than the norm, all children with autism should be screened for suicide ideation or attempts," Angela A. Gorman, Ph.D., said at a poster presentation at the meeting.

Among the 179 autistic children, 77% of those with suicide ideation or attempts were depressed, but only 28% of those with depression had suicide ideation or attempts. Among autistic children without depression, 95% had no suicide ideation or attempts, reported Dr. Gorman, a clinical psychologist in the department of psychiatry at Pennsylvania State College of Medicine, Hershey, and her associates.

The autistic children ranged in age from 1 to 16 years; 68% had high-function autism (defined as an IQ of 80 or higher), and the rest had low-functioning autism. The 35 nonautistic children with depression ranged in age from 8 to 16 years, and the 186 typical children were 6-12 years old.

Males comprised 84% of the autistic group, 26% of the nonautistic depressed group, and 44% of the typical group. The proportions of parents whose occupations were professional or managerial (indicating higher socioeconomic status) were 37% in the autistic group, 51% in the nonautistic with depression, and 51% in the typical group. The study cohort came mainly from rural, central Pennsylvania, where white children made up 92% of the autistic group, 94% of the nonautistic with depression, and 78% of the typical group.

The study assessed numerous variables to identify multiple risk factors in children with autism. Suicide ideation or attempts were more common in autistic males (15%) than females (7%); children with nonprofessional parents (16%), compared with those with professional parents (10%); black or Hispanic children (28%), compared with white or Asian children (13%); and in youths aged 10-16 years (32%), compared with those aged 1-9 years (10%).

Rates of suicide ideation or attempts increased with the number of risk factors, with rates of 1l%-71% in children with two to four of these demographic risk factors (male sex, lower socioeconomic status, black or Hispanic race/ethnicity and older age), Dr. …

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