Review

. 2020 Jun;29(6):759-776.

doi: 10.1007/s00787-018-01270-9. Epub 2019 Jan 25.

Psychosocial risk factors for suicidality in children and adolescents

J J Carballo¹, C Llorente¹, L Kehrmann¹, I Flamarique², A Zuddas³, D Purper-Ouakil⁴, P J Hoekstra⁵, D Coghill^{6

7

8

9}, U M E Schulze¹⁰, R W Dittmann¹¹, J K Buitelaar¹², J Castro-Fornieles^{2

13

14}, K Lievesley^{15

16

17}, Paramala Santosh^{18

19

20}, C Arango¹; STOP Consortium

Collaborators, Affiliations

Collaborators

STOP Consortium:
Alastair Sutcliffe, Sarah Curran, Laura Selema, Robert Flanagan, Ian Craig, Nathan Parnell, Keren Yeboah, Regina Sala, Jatinder Singh, Federico Fiori, Florence Pupier, Loes Vinkenvleugel, Jeffrey Glennon, Mireille Bakker, Cora Drent, Elly Bloem, Mark-Peter Steenhuis, Ruth Berg, Alexander Häge, Mahmud Ben Dau, Konstantin Mechler, Sylke Rauscher, Sonja Aslan, Simon Schlanser, Ferdinand Keller, Alexander Schneider, Paul Plener, Jörg M Fegert, Jacqui Paton, Murray Macey, Noha Iessa, Kolozsvari Alfred, Furse Helen, Penkov Nick, Claire Baillon, Hugo Peyre, David Cohen, Olivier Bonnot, Julie Brunelle, Nathalie Franc, Pierre Raysse, Véronique Humbertclaude, Alberto Rodriguez-Quiroga, Covadonga Martínez Díaz-Caneja, Ana Espliego, Jessica Merchán, Cecilia Tapia, Immaculada Baeza, Soledad Romero, Amalia La Fuente, Ana Ortiz, Manuela Pintor, Franca Ligas, Francesca Micol Cera, Roberta Frongia, Bruno Falissard, Ameli Schwalber, Juliane Dittrich, Andrea Wohner, Katrin Zimmermann, Andrea Schwalber, Katherine Aitchison

Affiliations

¹ Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.
² Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain.
³ Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, and "A. Cao" Paediatric Hospital, "G. Brotzu" Hospital Trust, Cagliari University Hospital, Cagliari, Italy.
⁴ CHRU Montpellier, Hôpital Saint Eloi, Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, France.
⁵ Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
⁶ Department of Paediatrics, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
⁷ Department of Psychiatry, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
⁸ Murdoch Children's Research Institute, Melbourne, Australia.
⁹ Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK.
¹⁰ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
¹¹ Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
¹² Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
¹³ Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain.
¹⁴ Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain.
¹⁵ Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
¹⁶ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK.
¹⁷ HealthTracker Ltd, Gillingham, Kent, UK.
¹⁸ Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK. paramala.1.santosh@kcl.ac.uk.
¹⁹ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK. paramala.1.santosh@kcl.ac.uk.
²⁰ HealthTracker Ltd, Gillingham, Kent, UK. paramala.1.santosh@kcl.ac.uk.

PMID: 30684089
PMCID: PMC7305074
DOI: 10.1007/s00787-018-01270-9

Review

Psychosocial risk factors for suicidality in children and adolescents

J J Carballo et al. Eur Child Adolesc Psychiatry. 2020 Jun.

. 2020 Jun;29(6):759-776.

doi: 10.1007/s00787-018-01270-9. Epub 2019 Jan 25.

Authors

Collaborators

STOP Consortium:
Alastair Sutcliffe, Sarah Curran, Laura Selema, Robert Flanagan, Ian Craig, Nathan Parnell, Keren Yeboah, Regina Sala, Jatinder Singh, Federico Fiori, Florence Pupier, Loes Vinkenvleugel, Jeffrey Glennon, Mireille Bakker, Cora Drent, Elly Bloem, Mark-Peter Steenhuis, Ruth Berg, Alexander Häge, Mahmud Ben Dau, Konstantin Mechler, Sylke Rauscher, Sonja Aslan, Simon Schlanser, Ferdinand Keller, Alexander Schneider, Paul Plener, Jörg M Fegert, Jacqui Paton, Murray Macey, Noha Iessa, Kolozsvari Alfred, Furse Helen, Penkov Nick, Claire Baillon, Hugo Peyre, David Cohen, Olivier Bonnot, Julie Brunelle, Nathalie Franc, Pierre Raysse, Véronique Humbertclaude, Alberto Rodriguez-Quiroga, Covadonga Martínez Díaz-Caneja, Ana Espliego, Jessica Merchán, Cecilia Tapia, Immaculada Baeza, Soledad Romero, Amalia La Fuente, Ana Ortiz, Manuela Pintor, Franca Ligas, Francesca Micol Cera, Roberta Frongia, Bruno Falissard, Ameli Schwalber, Juliane Dittrich, Andrea Wohner, Katrin Zimmermann, Andrea Schwalber, Katherine Aitchison

Affiliations

¹ Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.
² Child and Adolescent Psychiatry and Psychology Department, 2014SGR489, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, Barcelona, Spain.
³ Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, and "A. Cao" Paediatric Hospital, "G. Brotzu" Hospital Trust, Cagliari University Hospital, Cagliari, Italy.
⁴ CHRU Montpellier, Hôpital Saint Eloi, Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, France.
⁵ Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
⁶ Department of Paediatrics, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
⁷ Department of Psychiatry, School of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
⁸ Murdoch Children's Research Institute, Melbourne, Australia.
⁹ Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK.
¹⁰ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
¹¹ Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
¹² Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
¹³ Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain.
¹⁴ Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain.
¹⁵ Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
¹⁶ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK.
¹⁷ HealthTracker Ltd, Gillingham, Kent, UK.
¹⁸ Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK. paramala.1.santosh@kcl.ac.uk.
¹⁹ Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Foundation Trust, London, UK. paramala.1.santosh@kcl.ac.uk.
²⁰ HealthTracker Ltd, Gillingham, Kent, UK. paramala.1.santosh@kcl.ac.uk.

PMID: 30684089
PMCID: PMC7305074
DOI: 10.1007/s00787-018-01270-9

Abstract

Suicidality in childhood and adolescence is of increasing concern. The aim of this paper was to review the published literature identifying key psychosocial risk factors for suicidality in the paediatric population. A systematic two-step search was carried out following the PRISMA statement guidelines, using the terms 'suicidality, suicide, and self-harm' combined with terms 'infant, child, adolescent' according to the US National Library of Medicine and the National Institutes of Health classification of ages. Forty-four studies were included in the qualitative synthesis. The review identified three main factors that appear to increase the risk of suicidality: psychological factors (depression, anxiety, previous suicide attempt, drug and alcohol use, and other comorbid psychiatric disorders); stressful life events (family problems and peer conflicts); and personality traits (such as neuroticism and impulsivity). The evidence highlights the complexity of suicidality and points towards an interaction of factors contributing to suicidal behaviour. More information is needed to understand the complex relationship between risk factors for suicidality. Prospective studies with adequate sample sizes are needed to investigate these multiple variables of risk concurrently and over time.

Keywords: Adolescents; Children; Psychosocial; Questionnaire; Resilience; Risk; Suicidality; Web-based; Youth.

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Conflict of interest statement

Professor Paramala Santosh, is the CEO, Director and stockholder in HealthTracker Ltd. Dr. K. Lievesley is a Project Manager employed at HealthTracker Ltd. Dr. Dittmann has received compensation for serving as consultant or speaker, or he or the institution he works for have received research support or royalties from the organizations or companies indicated: EU (FP7 Programme), US National Institute of Mental Health (NIMH), German Federal Ministry of Health/Regulatory Agency (BMG/BfArM), German Federal Ministry of Education and Research (BMBF), German Research Foundation (DFG), Volkswagen Foundation; Boehringer Ingelheim, Ferring, Janssen-Cilag, Lilly, Lundbeck, Otsuka, Servier, Shire, Sunovion/Takeda and Theravance. Dr. Dittmann owns Eli Lilly stock. Dr. Zuddas has been a consultant to or has received honoraria or grants from EU (FP7 Programme), Angelini, Lundbeck, Janssen, Roche, Servier, Shire, Takeda, Vifor. Prof. Coghill reports grants and personal fees from Shire, personal fees from Janssen-Cilag, personal fees from Lilly, grants and personal fees from Vifor, personal fees from Novartis, personal fees from Flynn Pharma, personal fees from Medice, personal fees from Oxford University Press, outside the submitted work. Dr. Arango has been a consultant to or has received honoraria or grants from Acadia, Abbot, AMGEN, AstraZeneca, Bristol-Myers Squibb, Janssen-Cilag, Lundbeck, Merck, Otsuka, Pfizer, Roche, Servier, Sumitomo-Dainippon Pharma, Shire, Takeda, Teva and Schering Plough. Dr Purper-Ouakil has been consultant for Shire, Boiron, Mensia and has received honoraria or travel grants from Shire, Otsuka, Medice, Jannssen-Cilag, Ardix. None of the other authors have any conflicts of interest or disclosures to declare. Part of this data has been included in an FP7 STOP Report to the European Union.

Figures

**Fig. 1**
Study selection flowchart (using PRISMA guidelines) [7]

See this image and copyright information in PMC

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References

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Psychosocial risk factors for suicidality in children and adolescents

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Psychosocial risk factors for suicidality in children and adolescents

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