January 14, 2019
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Parents unaware of adolescents’ suicidal thoughts; teens deny parents’ concerns

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Photo of Jacqueline Grupp-Phelan
Jacqueline Grupp-Phelan

Half of parents were unaware that their teens had thoughts of killing themselves, and when parents reported that their children had thoughts of suicide, nearly half of those children denied having them, according to a study published in Pediatrics.

Jason D. Jones, PhD, of the department of child and adolescent psychiatry and behavioral sciences at Children’s Hospital of Philadelphia, and colleagues studied 5,137 adolescents aged 11 to 17 years (mean age, 14.53 years; 52.1% girls) from the Philadelphia Neurodevelopmental Cohort, who were recruited from a large pediatric health care network. Racial minorities made up 43% of the adolescent population. The adolescents and their parents completed a clinical interview designed to screen for symptoms of major psychiatric disorders, including questions about adolescents’ lifetime suicidal thoughts.

The adolescents were asked questions including, “Have you ever thought about killing yourself? and “Have you ever thought a lot about death or dying?”

Jones and colleagues reported moderate agreement between the parent and adolescent reports of adolescents’ suicidal thoughts (kappa = 0.466) and low agreement on thoughts about death or dying (kappa = 0.171).

Fifty percent of the parents reported being unaware that their teens had suicidal thoughts, and 75.6% of the parents reported not knowing that their adolescents had recurrent thoughts of death. Almost half (48%) of the adolescents denied suicidal thoughts, whereas 67.5% denied the thoughts of death that their parents had reported.

The researchers reported that older adolescent age was associated with decreased odds of parental unawareness and of adolescent denial.

In an accompanying editorial, Khyati Brahmbhatt, MD, and Jacqueline Grupp-Phelan, MD, MPH, of the University of California, San Francisco Benioff Children’s Hospitals, wrote that “accurate identification and intervention for suicidal ideation and underlying risk factors are paramount to reducing the risk of suicide. ... Further research to improve our understanding of factors driving the denial of symptoms by adolescents and its relation to the risk for suicide attempts is needed.”

Grupp-Phelan told Infectious Diseases in Children that “this study has the advantage of being the first large study to show that almost half of parents were unaware that their teen was having suicidal thoughts. Another very interesting finding, which expands our previous knowledge, is that parents are aware of suicidal symptoms that their teen may deny. This underscores how important it is the get both the child and parent reports to increase case finding.

“The most important take home message for parents is to ask your teen how they are doing, and if you notice a change in behavior or energy level, get help from their primary care provider or mental health professional.” – by Bruce Thiel

Disclosures : Jones, Brahmbhatt and Grupp-Phelan reports no relevant financial disclosures. Please see the full study for the other authors’ relevant financial disclosures.