Irritability, depressive mood tied to higher suicidality risk in adolescence

 

Children who are particularly irritable, depressive, and anxious might be at greater risk of suicidality in adolescence, according to a population-based cohort study.

Researchers enrolled 1,430 participants from the Québec Longitudinal Study of Child Development, aged 6-12 years, and performed yearly or biyearly assessments over a follow-up of 5 months to 17 years, according to a study published online March 28 in JAMA Psychiatry (doi: 10.1001/jamapsychiatry.2018.0174).

They found that girls who rated highly for irritability and for the depressive/anxious mood profile on the Behavior Questionnaire, a measure created for Canada’s National Longitudinal Study of Children and Youth, had a threefold higher risk of suicidality (odds ratio, 3.07; 95% confidence interval, 1.54-6.12). Meanwhile, boys had a twofold higher risk (OR, 2.13; 95% CI, 0.95-4.78), compared with children with low irritability and depressive/anxious mood.

“Exploratory analyses by sex indicated that this association was more important for girls than boys, as indicated by the need to prevent the exposure among 5 girls to avoid 1 case of suicidality,” wrote Massimiliano Orri, PhD, and his associates.

The rates of suicidality in children with high irritability and high depressive/anxious mood were 16.4%, compared with 11% in the group with the lowest symptom levels.

Even in children with only moderate irritability and low depressive/anxious mood, a significant increase was found in the odds of showing suicidality, compared with the reference group (OR, 1.51; 95% CI, 1.02-2.25).

“Although previous studies reported associations between irritability during childhood and adolescence and later depression, anxiety, and suicidality, we found that even moderate levels of irritability may contribute to suicidal risk,” wrote Dr. Orri of Bordeaux Population Health Research Centre, at the Institut National de la Santé et de la Recherche Medicale in France. “Such results indicate that children presenting with only irritability symptoms may benefit from an assessment for suicidal behaviors.”

 

Children with a high depressive/anxious mood profile showed the same odds of suicidality as those of the reference group.

The authors noted that there was considerably stability in developmental profiles, so children who showed the highest levels of symptoms at age 6 were likely to exhibit those same high levels at age 12.

They also commented on their study’s use of an “innovative, person-centered approach” to describe the joint course of these moods over the time course of the study.

The investigators cited several limitations. One is that the assessment of childhood symptoms were based on teachers only, so depressive/anxious mood might have been underrated compared with irritability “because internalizing symptoms may be more difficult to observe in a school setting than externalized symptoms.”

Dr. Orri and two associates reported receiving support from the Canadian Institutes of Health Research. The other researchers cited funding from the National Alliance for Research on Schizophrenia and Depression and the Fonds de Recherche du Québec. No other financial disclosures were reported. The Québec Longitudinal Study of Child Development was supported by several entities, including the Québec Government’s Ministry of Health, Ministry of Education, and Ministry of Family Affairs.

[email protected]

SOURCE: Orri M et al. JAMA Psychiatry. 2018 Mar 28. doi: 10.1001/jamapsychiatry.2018.0174.

 

Children who are particularly irritable, depressive, and anxious might be at greater risk of suicidality in adolescence, according to a population-based cohort study.

Researchers enrolled 1,430 participants from the Québec Longitudinal Study of Child Development, aged 6-12 years, and performed yearly or biyearly assessments over a follow-up of 5 months to 17 years, according to a study published online March 28 in JAMA Psychiatry (doi: 10.1001/jamapsychiatry.2018.0174).

They found that girls who rated highly for irritability and for the depressive/anxious mood profile on the Behavior Questionnaire, a measure created for Canada’s National Longitudinal Study of Children and Youth, had a threefold higher risk of suicidality (odds ratio, 3.07; 95% confidence interval, 1.54-6.12). Meanwhile, boys had a twofold higher risk (OR, 2.13; 95% CI, 0.95-4.78), compared with children with low irritability and depressive/anxious mood.

“Exploratory analyses by sex indicated that this association was more important for girls than boys, as indicated by the need to prevent the exposure among 5 girls to avoid 1 case of suicidality,” wrote Massimiliano Orri, PhD, and his associates.

The rates of suicidality in children with high irritability and high depressive/anxious mood were 16.4%, compared with 11% in the group with the lowest symptom levels.

Even in children with only moderate irritability and low depressive/anxious mood, a significant increase was found in the odds of showing suicidality, compared with the reference group (OR, 1.51; 95% CI, 1.02-2.25).

“Although previous studies reported associations between irritability during childhood and adolescence and later depression, anxiety, and suicidality, we found that even moderate levels of irritability may contribute to suicidal risk,” wrote Dr. Orri of Bordeaux Population Health Research Centre, at the Institut National de la Santé et de la Recherche Medicale in France. “Such results indicate that children presenting with only irritability symptoms may benefit from an assessment for suicidal behaviors.”

 

Children with a high depressive/anxious mood profile showed the same odds of suicidality as those of the reference group.

The authors noted that there was considerably stability in developmental profiles, so children who showed the highest levels of symptoms at age 6 were likely to exhibit those same high levels at age 12.

They also commented on their study’s use of an “innovative, person-centered approach” to describe the joint course of these moods over the time course of the study.

The investigators cited several limitations. One is that the assessment of childhood symptoms were based on teachers only, so depressive/anxious mood might have been underrated compared with irritability “because internalizing symptoms may be more difficult to observe in a school setting than externalized symptoms.”

Dr. Orri and two associates reported receiving support from the Canadian Institutes of Health Research. The other researchers cited funding from the National Alliance for Research on Schizophrenia and Depression and the Fonds de Recherche du Québec. No other financial disclosures were reported. The Québec Longitudinal Study of Child Development was supported by several entities, including the Québec Government’s Ministry of Health, Ministry of Education, and Ministry of Family Affairs.

[email protected]

SOURCE: Orri M et al. JAMA Psychiatry. 2018 Mar 28. doi: 10.1001/jamapsychiatry.2018.0174.

 

Children who are particularly irritable, depressive, and anxious might be at greater risk of suicidality in adolescence, according to a population-based cohort study.

Researchers enrolled 1,430 participants from the Québec Longitudinal Study of Child Development, aged 6-12 years, and performed yearly or biyearly assessments over a follow-up of 5 months to 17 years, according to a study published online March 28 in JAMA Psychiatry (doi: 10.1001/jamapsychiatry.2018.0174).

They found that girls who rated highly for irritability and for the depressive/anxious mood profile on the Behavior Questionnaire, a measure created for Canada’s National Longitudinal Study of Children and Youth, had a threefold higher risk of suicidality (odds ratio, 3.07; 95% confidence interval, 1.54-6.12). Meanwhile, boys had a twofold higher risk (OR, 2.13; 95% CI, 0.95-4.78), compared with children with low irritability and depressive/anxious mood.

“Exploratory analyses by sex indicated that this association was more important for girls than boys, as indicated by the need to prevent the exposure among 5 girls to avoid 1 case of suicidality,” wrote Massimiliano Orri, PhD, and his associates.

The rates of suicidality in children with high irritability and high depressive/anxious mood were 16.4%, compared with 11% in the group with the lowest symptom levels.

Even in children with only moderate irritability and low depressive/anxious mood, a significant increase was found in the odds of showing suicidality, compared with the reference group (OR, 1.51; 95% CI, 1.02-2.25).

“Although previous studies reported associations between irritability during childhood and adolescence and later depression, anxiety, and suicidality, we found that even moderate levels of irritability may contribute to suicidal risk,” wrote Dr. Orri of Bordeaux Population Health Research Centre, at the Institut National de la Santé et de la Recherche Medicale in France. “Such results indicate that children presenting with only irritability symptoms may benefit from an assessment for suicidal behaviors.”

 

Children with a high depressive/anxious mood profile showed the same odds of suicidality as those of the reference group.

The authors noted that there was considerably stability in developmental profiles, so children who showed the highest levels of symptoms at age 6 were likely to exhibit those same high levels at age 12.

They also commented on their study’s use of an “innovative, person-centered approach” to describe the joint course of these moods over the time course of the study.

The investigators cited several limitations. One is that the assessment of childhood symptoms were based on teachers only, so depressive/anxious mood might have been underrated compared with irritability “because internalizing symptoms may be more difficult to observe in a school setting than externalized symptoms.”

Dr. Orri and two associates reported receiving support from the Canadian Institutes of Health Research. The other researchers cited funding from the National Alliance for Research on Schizophrenia and Depression and the Fonds de Recherche du Québec. No other financial disclosures were reported. The Québec Longitudinal Study of Child Development was supported by several entities, including the Québec Government’s Ministry of Health, Ministry of Education, and Ministry of Family Affairs.

[email protected]

SOURCE: Orri M et al. JAMA Psychiatry. 2018 Mar 28. doi: 10.1001/jamapsychiatry.2018.0174.