Suicide patterns in children and adolescents: a review from a pediatric institution in England
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ORIGINAL ARTICLE
Suicide patterns in children and adolescents: a review from a pediatric institution in England Khairul Zainum 1,2 & Marta C. Cohen 1
Accepted: 27 February 2017 # Springer Science+Business Media New York 2017
Abstract Suicide is a catastrophic event to both families and communities yet it is potentially preventable. This study aims to determine incidence and patterns of suicide in children and young adolescents in our region, raise awareness of this entity as a potentially preventable cause of death in this age group, and identify its possible associated risk factors. We retrospectively reviewed suicide cases presenting as sudden unexpected death in children and adolescents that underwent coronial post-mortems at our institution. This is the largest pathological review of completed suicide in children and young adolescents within a single institution in the United Kingdom. We identified 23 suicide cases during a 12 year period from 2003 to 2015, in which 18 cases (78%) were male and 5 cases (22%) were female. The age range was from 8 to 16 years (mean age 12.82 +/− 2.52 SD). With the exception of one case, all of the victims were Caucasian. The majority, 19 cases (81%), were found dead inside their place of residence, 15 of whom were discovered in their own bedrooms. Twenty-one cases (91%) died from neck compression due to hanging; 6 cases (26%) had used the cord of a dressing gown and 5 (22%) opted to use a belt as the ligature. Two cases (9%) that died from multiple-drug toxicity were female. In 7 cases (30.5%) there was evidence of self-harm and in 3 cases (13%) there was a history of previous suicide attempts. Petechial hemorrhages were found at autopsy in more than half of hanging victims and only three cases (14%) displayed dual distribution
* Marta C. Cohen [email protected] 1
Department of Histopathology, Sheffield Children’s Hospital Foundation Trust, Western Bank, S10 2TH, Sheffield, UK
2
Department of Forensic Medicine, Hospital Sultanah Aminah, Johor Bharu, Johore, Malaysia
of post-mortem hypostasis (back and legs). Seven victims (30.5%) left some form of suicide message to family members and friends, 2 of which wrote the message on their arm. Parental separation, conflict with parents, and depression, were common amongst decedents prior to committing suicide. Substance abuse was uncommon in suicide within our cases. Valuable information is available from thorough review of suicide data in children and young adolescents from a single institution. Pathologists and clinicians can play crucial roles in identifying potential risk factors that may contribute to prevent future deaths. Keywords Children . Adolescents . Hanging . Post-mortem . Suicide
Introduction Suicide is increasingly related to mental health problems and is potentially preventable. In the United Kingdom (UK), the reported incidence in 2014 was 23.9 deaths per 100,000 males in the 45–59-year-old age group [1]. According to the World Health Organization (WHO), there has been a 60% global increase in recorded suic
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