Suicidal Thoughts More Common in Kids With Autism: Study

But expert advises parents not to panic over mood changes

Thursday, March 21, 2013

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THURSDAY, March 21 (HealthDay News) -- Children with autism may have a higher-than-average risk of contemplating or attempting suicide, a new study suggests.
Researchers found that mothers of children with autism were much more likely than other moms to say their child had talked about or attempted suicide: 14 percent did, versus 0.5 percent of mothers whose kids didn't have the disorder.
The behavior was more common in older kids (aged 10 and up) and those whose mothers thought they were depressed, as well as kids whose moms said they were teased.
An autism expert not involved in the research, however, said the study had limitations, and that the findings "should be interpreted cautiously."
One reason is that the information was based on mothers' reports, and that's a limitation in any study, said Cynthia Johnson, director of the Autism Center at Children's Hospital of Pittsburgh.
Johnson also said mothers were asked about suicidal and "self-harming" talk or behavior. "A lot of children with autism talk about or engage in self-harming behavior," she said. "That doesn't mean there's a suicidal intent."
Still, Johnson said it makes sense that children with autism would have a higher-than-normal risk of suicidal tendencies. It's known that they have increased rates of depression and anxiety symptoms, for example.
The issue of suicidal behavior in these kids "is an important one," Johnson said, "and it deserves further study."
Autism spectrum disorders are a group of developmental brain disorders that hinder a child's ability to communicate and interact socially. They range from severe cases of "classic" autism to the relatively mild form called Asperger's syndrome.
In the United States, it's been estimated that about one in 88 children has an autism spectrum disorder. This week, the U.S. Centers for Disease Control and Prevention revised that prevalence to as high as one in 50 children.
The new findings, reported in the journal Research in Autism Spectrum Disorders, are based on surveys of nearly 800 mothers of children with an autism spectrum disorder, 35 whose kids were free of autism but suffered from depression, and nearly 200 whose kids had neither disorder. The children ranged in age from 1 to 16, and the autism spectrum disorder cases ranged in severity.
Non-autistic children with depression had the highest rate of suicidal talk and behavior, according to mothers -- 43 percent said it was a problem at least "sometimes."
Among children with autism spectrum disorders, those with depression symptoms were at greatest risk of suicidal talk or attempts. Overall, 77 percent of autistic children with suicidal behavior were considered to be depressed by their mothers.
The results highlight the fact that children with autism spectrum disorders suffer from a range of issues other than the classic autism symptoms, said Angela Gorman, one of the study's researchers.
"Sometimes these other things get overshadowed by the [autism spectrum disorder] symptoms themselves," said Gorman, an assistant professor of child psychiatry at Penn State College of Medicine, in Hershey.
She suggested that parents pay close attention to what "normal behavior" is for their child, so they can notice when a potential red flag arises, such as an increase in sad moods or angry outbursts.
"If you have any concerns, take your child in for an evaluation with a psychologist or psychiatrist," Gorman said.
Although the study tied having autism to more suicidal talk or attempts, it didn't prove that these children are more likely to commit suicide.
Besides depression symptoms, bullying also seemed to be a risk factor for suicidal behavior, the researchers found. Kids with autism whose mothers said they were teased were three times more likely to show such behavior.
And teasing was common, reported by 57 percent of mothers. That's in line with a recent study that found nearly half of U.S. teens with autism spectrum disorders have been bullied by other kids.
Johnson agreed that these latest findings underscore the many issues children with autism spectrum disorders face. "These are vulnerable children," she said.
Johnson said she already talks with parents about the increased risks of depression and anxiety associated with autism. As for formal screening for suicidal behavior, that might be done in some cases, she said. But there's no universal guideline on screening.
Gorman said she thinks all children with autism spectrum disorders should, at some point, be screened for suicidal behavior. It would make sense, she said, to wait until children are older, but there are no set-in-stone rules for how or when to screen.
And if your child is showing potential warning signs? Gorman said therapy would depend on each child's situation, including how severe the autism is and what co-existing problems -- such as depression -- there might be.
Johnson said that if parents are worried about changes in their child's behavior, they should bring it up to their doctor. But she also stressed that mood or behavior shifts could have any number of causes. "My advice to parents is, don't panic," she said.

SOURCES: Angela Gorman, Ph.D., assistant professor, child psychiatry, Penn State College of Medicine, Hershey; Cynthia Johnson, Ph.D., director, Autism Center, Children's Hospital of Pittsburgh; January 2013 Research in Autism Spectrum Disorders

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