Symptoms and Diagnoses Prior to Suicide in Children and Young Adults—A Swedish Medical Record Review

TL;DR

This study examines symptoms and diagnoses in children and young adults who died by suicide in Sweden to better understand and prevent youth suicide.

Contribution

The study provides new insights into the under-recognized symptoms and diagnoses in youth prior to suicide, emphasizing the need for improved mental health assessments.

Findings

Depressive symptoms, anxiety symptoms, and pain were the most commonly reported symptoms.

Mental and behavioral disorders, particularly neurotic and mood disorders, were the most frequent diagnoses.

Existing symptoms and diagnoses were insufficient to identify suicidality in youth.

Abstract

Public health relevance—How does this work relate to a public health issue?
Preventing suicide in children and young adults is an important global public health issue. This work is relevant due to its focus on understanding youth suicidality to prevent suicide and strengthen well-being in the younger generations.This study investigated symptoms and all DSM diagnoses among a national cohort of children and young adults that died by suicide in 2015.

Preventing suicide in children and young adults is an important global public health issue. This work is relevant due to its focus on understanding youth suicidality to prevent suicide and strengthen well-being in the younger generations.

This study investigated symptoms and all DSM diagnoses among a national cohort of children and young adults that died by suicide in 2015.

Public health significance—Why is this work of significance to public health?
This work offers an understanding of the proportions of symptoms and diagnoses in children and young adults prior to suicide in youth; relatively few had a history of symptoms and diagnoses.This work is of significance to public health due to its discussion of the complex interplay between the inner and outer world of the individual, including the physical, emotional, and social life worlds.

This work offers an understanding of the proportions of symptoms and diagnoses in children and young adults prior to suicide in youth; relatively few had a history of symptoms and diagnoses.

This work is of significance to public health due to its discussion of the complex interplay between the inner and outer world of the individual, including the physical, emotional, and social life worlds.

Public health implications—What are the key implications or messages for practitioners, policy makers, and/or researchers in public health?
The key implication for practitioners and policy makers in public health is the recommendation to consider the highlighted psychological aspects of mental health and well-being in building psychological resilience to suicide as well as improving challenging life situations to prevent suicide.The key implication for researchers in public health is the need to continue to incorporate various theoretical perspectives while further exploring the plurality of youth suicidality.

The key implication for practitioners and policy makers in public health is the recommendation to consider the highlighted psychological aspects of mental health and well-being in building psychological resilience to suicide as well as improving challenging life situations to prevent suicide.

The key implication for researchers in public health is the need to continue to incorporate various theoretical perspectives while further exploring the plurality of youth suicidality.

Suicide in children and young adults is a leading cause of premature mortality, and there is a need to develop a more profound understanding of the factors that contribute to these deaths. This study is part of the nationwide Retrospective Investigation of Health Care Utilization in Individuals who died by Suicide in Sweden 2015, conducted at Lund University, Sweden. The aim was to examine symptoms and diagnoses in children and young adults who died by suicide, as documented in their medical records at their last visits for primary care, somatic specialist care, or psychiatric care 24 months prior to suicide, and to apply contemporary psychological research in youth suicidality to the findings to formulate clinical implications. The proportions of symptoms and diagnoses in children (0–17 years), young adults (18–24 years), males, and females are described. The main symptoms noted in the cohort were depressive symptoms (28%), anxiety symptoms (26%), and pain (25%). The diagnoses predominately covered mental and behavioural disorders, and the most frequent of the mental and behavioural diagnoses were neurotic, stress-related, and somatoform disorders (32%) and mood (affective) disorders (29%). The diagnoses and symptoms were not sufficient to uncover suicidality in children and young adults. The clinical implications for alternative assessments and preventive interventions are discussed.