|
Abstract
|
OBJECTIVE: Suicidal thoughts and behaviors (STBs) in children are an escalating public health concern. This study focused on one understudied candidate risk factor, preschool-onset major depressive disorder (PO-MDD), as a predictor of persistent and emerging STBs from early childhood into preadolescence.
METHOD: Participants were 137 8-to 12-year-old children who met criteria for PO-MDD when they were aged 3-6 years, and a non-depressed sample of 53 age, income, and gender-matched peers. STBs were reported by caregivers (preschool, preadolescence) and children (preadolescence) using age-appropriate diagnostic interviews.
RESULTS: By preadolescence, children who had PO-MDD were 7.38 times more likely than their peers to have endorsed STBs after early childhood (p<.001; 67.9% versus 22.6%), including 6.71 times more likely to have engaged in suicide behaviors/attempts (p=.012; 21.9% versus 3.8%); they were also 8.98 times more likely to have endorsed STBs over the prior month (p=.005; 26.3% versus 3.8%). Similar findings emerged when limiting the PO-MDD group to children without preschool STBs, and when controlling for externalizing comorbidities, implicating PO-MDD as a unique diagnostic predictive risk factor. However, children who had PO-MDD with STBs were 3.46 times more likely than children who had PO-MDD without STBs to endorse later STBs (p=.018; 83.1% versus 54.2%), indicating substantial continuity of preschool STBs alongside strikingly high rates of emerging STBs into preadolescence.
CONCLUSION: PO-MDD is a strong risk-factor for the emergence and persistence of STBs into preadolescence. Children with PO-MDD would likely benefit from increased suicide screening, proactive safety planning, and early interventions.
Language: en |