APA 2021: Risk of suicidal behavior in childhood schizophrenia is elevated by race

The following article is part of the conference coverage of the American Psychiatric Association’s 2021 Annual Meeting, held virtually May 1-3, 2021. The team at Psychiatric Advisor will report on the latest news and research from leading experts in psychiatry. Check back for more from APA 2021.

According to study findings presented at the American Psychiatric Association’s annual meeting, held virtually May 1-3, 2021, black and Hispanic children diagnosed with childhood schizophrenia have a one-third higher risk. to exhibit suicidal behavior.

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Study investigators performed a cross-sectional study using data from a national sample of pediatric psychiatric patients to assess the risk of suicidal behavior in patients with childhood schizophrenia relative to other psychiatric disorders and to identify the RR by demographic parameters.

Data were analyzed for a sample of 39,615 hospitalized pediatric psychiatric patients aged 6 to 12 years. Investigators compared children with a primary diagnosis of schizophrenia (n = 2,140) to children with other psychiatric disorders (n = 37,475). Suicidal behavior among the cohorts was identified as the codiagnosis of suicide and intentional self-harm. A logistic regression analysis was performed to measure the risk of suicidal behavior in the childhood-onset schizophrenia cohort compared to the non-schizophrenia cohort. The RR for suicidal behavior was then assessed based on race and socioeconomic strata.

A primary diagnosis of childhood schizophrenia was prevalent in 5.4% of the total inpatient sample. Compared to the non-schizophrenic cohort, black patients had a 1.4 times higher risk of childhood schizophrenia (95% CI, 1.24-1.57) and Hispanic patients had a 1.3 times higher risk (95% CI, 1.13-1.46). The risk of childhood schizophrenia appears to increase with decreasing median household income: children from families with household income below the 25th percentile were 1.4 times (95% CI, 1.22-1.66) more likely to be diagnosed with schizophrenia than children from higher-income families.

After controlling for demographics and comorbidities, the investigators found that there was no statistically significant difference in the risk of suicidal behavior between the pediatric psychiatric cohorts. However, a statistically significant increased risk of suicidal behavior was reported in black (RR 1.33; 95% CI, 1.09-1.63) and Hispanic (RR 1.31; 95% CI, 1.06-1.63) in the childhood-onset schizophrenia cohort. vs the non-schizophrenic cohort.

Study investigators suggested that black and Hispanic children with a diagnosis of schizophrenia are 31% and 33% more likely to be at risk for suicidal behavior. In order to prevent suicides in children, the researchers indicated that clinicians should identify at-risk groups and individuals early on.

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Prabhudesai S, Patel R, Verma S. Suicidal behavior in childhood schizophrenia: perceptions of 39,615 inpatient psychiatry in the United States. Presented at: APA Annual Meeting May 1-3, 2021. Abstract/Poster: 4029.