Childhood maltreatment increases suicide risk

1. More than 5% of youth who had experienced maltreatment (physical, sexual, or emotional abuse or neglect) reported a previous suicide attempt.

2. Suicide attempts in maltreated youth were most significantly associated with prior physical abuse, emotional abuse, and emotional neglect.

Evidence Rating Level: 2 (Good)

Study Rundown: Suicide is the third leading cause of death among youth ages 15 to 24 years in the United States and accounts for 20% of all deaths among those <25 years old in Canada. At particular risk are marginalized populations, such as homeless or street youth (those who live or work all or part of their time on the street), who often have a history of childhood maltreatment. In order to implement prevention efforts, it is critical to understand why street youth are at such high risk of suicide. As such, authors of the current study sought to examine the risk of attempted suicide in relation to childhood maltreatment in street youth. Data was taken from the At Risk Youth Study (ARYS) in Vancouver, Canada between 2005 and 2013. Results indicated that more than 5% of street youth sampled who had experienced maltreatment (physical, sexual, or emotional abuse or neglect) reported a previous suicide attempt. These suicide attempts were most significantly associated with specific forms of childhood maltreatment, namely physical abuse, emotional abuse, and emotional neglect. Study limitations include recall bias and difficulty in distinguishing suicide from drug overdose. Nonetheless, these findings may assist clinicians to screen for and identify suicidal behavior in at-risk youth.

Click to read the study, published today in Pediatrics

Relevant Reading: Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality.

In-Depth [prospective cohort study]: A total of 660 youth ages 14 to 26 (median age 22 years, 68.2% male, 24.6% Aboriginal) were included in this study. Data from the ARYS was used from September 2005 to November 2013 with eligible youth being street-involved, defined as having been without housing in the preceding 6 months. Participants completed the Childhood Trauma Questionnaire (CTQ), which assesses self-reported sexual, physical, and emotional abuse, as well as neglect. The prevalence of childhood maltreatment ranged from 16.8% (sexual abuse) to 45.2% (emotional abuse), while suicide attempts were reported by 5.3% of participants. The forms of maltreatment found to be significantly associated with suicide attempts were physical abuse (adjusted hazard ratio [aHR]: 4.47; 95% CI: 2.12-9.42) emotional abuse (aHR: 4.92; 95% CI: 2.11-11.5), and emotional neglect (aHR: 3.08; 95% CI: 1.05-9.03). Furthermore, increasing severity of childhood maltreatment, as indicated by the CTQ score, was associated with suicide attempts for all forms of maltreatment except sexual abuse.

Image: PD

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