Contributing Factors and Mental Health Outcomes of First Suicide Attempt During Childhood and Adolescence: Results From a Nationally Representative Study

J Clin Psychiatry. 2017 Jun;78(6):e622-e630. doi: 10.4088/JCP.16m10876.


Objective: To investigate whether risk factors for suicide attempts differ in children and adolescents and to categorize adulthood mental health outcomes of child and adolescent suicide attempters in the general population.

Methods: Using a large (N = 34,653), nationally representative US adult sample, the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, we examined whether individuals who first attempted suicide during childhood (under the age of 13 years) differ from those who first attempted suicide during adolescence (13 through 17 years) in (1) contributing factors for first suicide attempt, including mental disorders and traumatic experiences that occurred before the first suicide attempt, parental history of mental disorders, and family poverty and (2) adulthood mental health outcomes, including lifetime and current prevalence of DSM-IV psychiatric disorders and quality of life measures.

Results: Suicide attempts during childhood (n = 104) were more strongly related to childhood maltreatment, while suicide attempts during adolescence (n = 415) were more strongly associated with major depressive episode. Compared to first suicide attempts during adolescence, first attempts during childhood were associated with increased risk for multiple suicide attempts (61.3% vs 32.6%), several psychiatric disorders (mania, hypomania, and panic disorder), and poorer social functioning during adulthood (all P values < .05).

Conclusions: Suicide attempts in children and adolescents substantially differ in contributing factors and adulthood mental health outcomes. Preventing childhood maltreatment and early intervention for psychiatric disorders may have broad benefits to reduce not only the suffering of these children and adolescents, but also the burden of suicide.

MeSH terms

  • Adolescent
  • Adult
  • Adult Survivors of Child Abuse / statistics & numerical data*
  • Age Factors
  • Aged
  • Child
  • Child of Impaired Parents / statistics & numerical data*
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / epidemiology*
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Parents / psychology*
  • Poverty / statistics & numerical data*
  • Prevalence
  • Risk Factors
  • Suicide, Attempted / statistics & numerical data*
  • United States / epidemiology
  • Young Adult