Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2018-0111
Trends in Psychiatry and Psychotherapy
Original Article

Characterization of suicidal behavior among children in a depressive episode: case series study

Caracterização do comportamento suicida em crianças em episódio depressivo: estudo de série de casos

Ana Luiza Pereira de Souza; Beatriz Werkhaizer Segolin; Paula Bedim Pessanha; Tânia Queiroz de Araújo Abreu; Yasmin Emi Enemu Mino; Filipe Augusto Cursino de Freitas; Nadja Cristiane Lappann Botti

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Abstract

Abstract Introduction Child suicidal behavior is related to specific childhood variations, constituting risk factors, including predisposing factors, internal factors, and environmental factors. Objective To characterize suicidal behavior among children aged 5 to 12 years diagnosed with a depressive episode. Methods Fifteen participants, aged 5 to 12, were assessed at a child and adolescent mental health center in Belo Horizonte, state of Minas Gerais, Brazil. All participants had a history of suicide attempt and were in a depressive episode at the time of assessment. Results Vulnerabilities related to the children themselves were self-harm, aggression, loss of an important family figure, sexual abuse, sexuality disorders, use of alcohol or other drugs, and ill-treatment. Factors of family structure and dynamics found were psychiatric illness in family members, family conflict or violence, abandonment or rejection, history of suicidal behavior in family, parents users of alcohol and other drugs, and separated parents. Factors related to school were bullying, school difficulties/delays, high school performance, bad behavior, physical aggression, school dropout, and aggressiveness. The main methods used in suicide attempts were injury by sharp or blunt objects and intentional self-poisoning. Conclusions Psychiatric comorbidities and a previous history of disturbances in the family and at school are important factors to consider with relation to suicidal behavior by children with depressive episodes.

Keywords

Suicide, child, depressive disorder

Resumo

Resumo Introdução O comportamento suicida infantil está relacionado com vicissitudes específicas da infância, representadas por fatores de risco, incluindo fatores predisponentes, internos e ambientais. Objetivo Caracterizar o comportamento suicida em crianças de 5 a 12 anos com diagnóstico de episódio depressivo. Métodos Quinze participantes, com idades entre 5 e 12 anos, foram avaliados em um centro de saúde mental da infância e adolescência de Belo Horizonte, MG, Brasil. Todos os participantes tinham histórico de tentativa de suicídio e estavam em um episódio depressivo no momento da avaliação. Resultados As vulnerabilidades relacionadas às próprias crianças foram automutilação, agressão, perda de uma figura familiar importante, abuso sexual, distúrbios da sexualidade, uso de álcool ou outras drogas e maus-tratos. Em relação a estrutura e dinâmica familiar, foram encontrados fatores como doença psiquiátrica na família, conflito ou violência familiar, abandono ou rejeição, histórico de comportamento suicida na família, pais usuários de álcool e outras drogas e pais separados. Os fatores relacionados à escola foram assédio moral, dificuldades/atrasos escolares, bom desempenho escolar, mau comportamento, agressão física, abandono escolar e agressividade. Os principais métodos utilizados nas tentativas de suicídio foram lesões por objetos pontiagudos ou contundentes e autoenvenenamento intencional. Conclusão As comorbidades psiquiátricas e o histórico prévio de distúrbios na família e na escola são fatores importantes a serem considerados em relação ao comportamento suicida em crianças com episódios depressivos.

Palavras-chave

Suicídio, criança, transtorno depressivo

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