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Assessment of suicidality in children and adolescents with diagnosis of high functioning autism spectrum disorder in a Turkish clinical sample

Authors Karakoç Demirkaya S, Tutkunkardaş MD, Mukaddes NM

Received 27 July 2016

Accepted for publication 30 September 2016

Published 11 November 2016 Volume 2016:12 Pages 2921—2926

DOI https://doi.org/10.2147/NDT.S118304

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Sevcan Karakoç Demirkaya,1 Mustafa Deniz Tutkunkardaş,2 Nahit Motavalli Mukaddes3

1Department of Child Psychiatry, Adnan Menderes University School of Medicine, Aydin, 2Department of Child Psychiatry, Istanbul School of Medicine, Istanbul University, Istanbul, 3Istanbul Institute of Child and Adolescent Psychiatry, Istanbul, Turkey

Objectives: Considering that suicide is one of the most common reasons of adolescent death worldwide, there is a lack of clinical awareness on suicidal behaviors of children and adolescents with autism spectrum disorder (ASD). The present study aims to assess the rate of suicidality (suicidal ideation, behaviors and attempts) and associated risk factors for suicidality in high functioning ASD.
Methods: Medical records of 55 adolescents (six girls, 49 boys), aged between 7–20 years, with diagnosis of ASD were reviewed. The participants were all able to speak fluently and had no significant limitations in intellectual functioning. Clinical assessment of participants was carried out on the basis of Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revision criteria and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Eskin’s Suicide Screening Questionnaire and sociodemographic data form including detailed history of suicidal behaviors were used. The study group was also divided into suicidal and non-suicidal groups for the purpose of comparing the results.
Results: The rate of suicidal behaviors was 29% and suicide attempt was 12.7%. Types of suicidality were behaviors (43.7%), thoughts (37.5%), and verbal declarations (18.7%). A number of bizarre acts were recorded. Rates of comorbid psychiatric disorders such as mood disorders, anxiety disorders and disruptive behaviors were 23.6%, 43.6% and 65.4% respectively. Groups with the psychotic features, positive family history for suicidal behaviors and completed suicide showed more suicidality than the non-suicidal group.
Conclusion: Consistent with the previous findings, rate of suicidality is higher in individuals with ASD. The type of suicidal behaviors showed some differences compared to typically developing individuals. The presence of psychotic features and positive family history for suicidality may be risk factors for suicidality in children and adolescents with ASD. To prevent suicide and implement protective health care systems, identifying the population at risk is crucial.

Keywords: autism, adolescent, child, suicidal attempt, suicidal ideation

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