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.

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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.


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.

This article originally appeared on Psychiatry Advisor