APA 2021: Suicidal Behavior Risk in Childhood-Onset Schizophrenia Elevated by Race

sad child
sad child
This study identifies the correlation between racial parameters and risk of suicidal behavior in childhood-onset schizophrenia.

The following article is a part of conference coverage from the American Psychiatric Association Annual Meeting 2021, held virtually from May 1 to 3, 2021. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the APA 2021.


Black and Hispanic children diagnosed with childhood-onset schizophrenia are at one-third higher risk of demonstrating suicidal behavior, according to study results presented at the American Psychiatric Association annual meeting, held virtually from May 1 to May 3, 2021.

The study investigators performed a cross-sectional study using data from a nationwide sample of pediatric psychiatric patients to evaluate the risk for suicidal behavior in patients with childhood-onset schizophrenia vs other psychiatric disorders and to identify RR by demographic parameters.

Data were analyzed for a sample of 39,615 pediatric psychiatric inpatients aged 6 to 12 years. The investigators compared children with a primary schizophrenia diagnosis (n=2140) to children with other psychiatric conditions (n=37,475). Suicidal behavior among the cohorts was identified as the codiagnosis of suicide and intentional self-inflicted injury. Logistic regression analysis was performed to measure the risk for suicidal behavior in the childhood-onset schizophrenia cohort vs the nonschizophrenia cohort. The RR for suicidal behavior was further evaluated by race and socioeconomic strata.

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

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

The study investigators suggested that Black and Hispanic children with a schizophrenia diagnosis are 31% and 33% more likely to be at risk for suicidal behavior. In order to prevent childhood suicides, 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-onset schizophrenia: Perceptions from 39,615 psychiatric inpatients from the United States. Presented at: APA annual meeting May 1-3, 2021. Abstract/Poster: 4029.