Suicide or accident? A psychological autopsy study of suicide in youths under the age of 16 compared to deaths labeled as accidents

Abstract

ObjectiveIn the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa.MethodWe used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84). We additionally constructed a suicide index to distinguish between the two causes of death.ResultsThe young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain.ConclusionIn line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling.

Revisão de literatura sobre suicídio na infância

“…There was a prevalence ranging from 48%-90% of deaths from suicide in childhood due to hanging, followed by 14%-22% by firearms and, to a lesser extent, 4%-7% due to poisoning, 7%-30% by precipitation and 2%-4% by drowning 4,[6][7][8][9][12][13][14]19,21,24,26,28,35,41 . In Singapore, 90% of deaths occurred due to precipitation and 9% by hanging 35 .…”

“…In 2010, studies more specific to the population under 14 years of age emerge, emphasizing personality traits, factors associated with bullying, psychosocial stress and its psychiatric implications 7,8,[33][34][35][36][37][38]40 . Schools and mental health care began to integrate forms of children suicide prevention, and the challenge of identifying the risk of suicide in this population stands out 8 .…”

“…Thus, many children watch hanging scenes in cartoons, paintings and television programs. It should be emphasized that this method does not require specific skills 7,12,19 . Therefore, the social, psychological and psychiatric circumstances involved in the death of children should be analyzed in order to sort them correctly.…”

“…Of these, 74% died by hanging and 13% by firearm 6 . In Norway 7 , a survey revealed that suicide corresponds to 61% of deaths from external causes in children aged 10-14 years. In Australia, suicide is the second cause of death (27.2%) in children aged 10-14 years 8 .…”

“…This setting has limitations and challenges with regard to suicide prevalence in children: underreporting of suicide deaths due to the difficulty or error in classifying them as such or registering them as accidental or due to undetermined causes 4,7,12 ; the combination of suicide statistics in the 10-19 years age group, which includes different periods of development and events, disregarding the fact that young people commit suicide for reasons other than children and the lack of hospital notifications in these cases. In addition, suicide is a taboo, where one believes that, due to their cognitive immaturity, children do not engage in suicidal acts 4,9,13,14 .…”