Level 1 autism spectrum disorder as a risk factor for suicide in a child: case report
DOI:
https://doi.org/10.25118/2763-9037.2024.v14.1193Keywords:
Autism spectrum disorder, child, risk factors, suicide, ASDAbstract
Introduction: Suicidal behavior is one in which the individual has thoughts, plans, and actions with the intention of ending their own life. This is a global public health problem. Recently, autism spectrum disorders have begun to be considered risk factor for suicidal behavior in children and adolescents. Method: Case report. Case presentation: A 12-year-old boy who made a suicide attempt, was admitted to the emergency department at Centro Psíquico da Adolescência e Infância. After a period of irregular treatment, this child made a suicide attempt. As an inpatient, autism spectrum disorder with comorbid depressive disorder was diagnosed after longitudinal and systematic assessments of multidisciplinary team. Treatment was performed according to clinical issues. Discussion: This patient had a form of autism spectrum disorder on which core aspects were not so evident. In this child, there was an overlap between depressive symptoms and symptoms of autism spectrum disorder. Despite social isolation being present, this patient proved capable to disguising his condition using techniques of social and behavioral imitation and camouflage with the aim of adapting to social environment. Conclusion: This study emphasizes the importance of longitudinal evaluation and multidisciplinary assessment to differential diagnosis and appropriate treatment. It also opens a window for further investigations of a possible association between autism spectrum disorders and suicidal behavior in youth.
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References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington: American Psychiatric Association; 2022.
Kirby AV, Bakian AV, Zhang Y, Bilder DA, Keeshin BR, Coon H. A 20-year study of suicide death in a statewide autism population. Autism Res. 2019;12(4):658-66. https://doi.org/10.1002/aur.2076 PMID:30663277 - PMCID:PMC6457664
McDonnell CG, DeLucia EA, Hayden EP, Anagnostou E, Nicolson R, Kelley E, Georgiades S, Liu X, Stevenson RA. An exploratory analysis of predictors of youth suicide-related behaviors in autism spectrum disorder: implications for prevention science. J Autism Dev Disord. 2020;50(10):3531-44. https://doi.org/10.1007/s10803-019-04320-6 PMID:31820342
Horowitz LM, Thurm A, Farmer C, Mazefsky C, Lanzillo E, Bridge JA, Greenbaum R, Pao M, Siegel M; Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC). Talking about death or suicide: prevalence and clinical correlates in youth with autism spectrum disorder in the psychiatric inpatient setting. J Autism Dev Disord. 2018;48(11):3702-10. https://doi.org/10.1007/s10803-017-3180-7 PMID:28624965 PMCID:PMC7410502
Yu Y, Ozonoff S, Miller M. Assessment of autism spectrum disorder. assessment. 2024;31(1):24-41. https://doi.org/10.1177/10731911231173089 PMID:37248660 PMCID:PMC10676043
Mayes SD, Gorman AA, Hillwig-Garcia J, Syed E. Suicide ideation and attempts in children with autism. Res Autism Spectr Disord. 2013;7(1):109-19. https://doi.org/10.1016/j.rasd.2012.07.009
Dell'Osso L, Luche RD, Gesi C, Moroni I, Carmassi C, Maj M. From Asperger's autistischen psychopathen to DSM-5 autism spectrum disorder and beyond: a subthreshold autism spectrum model. Clin Pract Epidemiol Ment Health. 2016;12:120-31. https://doi.org/10.2174/1745017901612010120 PMID:27867417 PMCID:PMC5095893
Wiggins LD, Rice CE, Barger B, Soke GN, Lee LC, Moody E, Edmondson-Pretzel R, Levy SE. DSM-5 criteria for autism spectrum disorder maximizes diagnostic sensitivity and specificity in preschool children. Soc Psychiatry Psychiatr Epidemiol. 2019;54(6):693-701. https://doi.org/10.1007/s00127-019-01674-1 PMID:30850887 PMCID:PMC6713264
Newell V, Phillips L, Jones C, Townsend E, Richards C, Cassidy S. A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability. Mol Autism. 2023;14(1):12. https://doi.org/10.1186/s13229-023-00544-7 PMID:36922899 - PMCID:PMC10018918
Cassidy SA, Gould K, Townsend E, Pelton M, Robertson AE, Rodgers J. Is camouflaging autistic traits associated with suicidal thoughts and behaviours? Expanding the interpersonal psychological theory of suicide in an undergraduate student sample. J Autism Dev Disord. 2020;50(10):3638-48. https://doi.org/10.1007/s10803-019-04323-3 PMID:31820344 - PMCID:PMC7502035
Renaud J, MacNeil SL, Vijayakumar L, Spodenkiewicz M, Daniels S, Brent DA, Turecki G. Suicidal ideation and behavior in youth in low- and middle-income countries: a brief review of risk factors and implications for prevention. Front Psychiatry. 2022;13:1044354. https://doi.org/10.3389/fpsyt.2022.1044354 PMID:36561636 PMCID:PMC9763724
Ribeiro JM, Moreira MR. An approach to suicide among adolescents and youth in Brazil. Cien Saude Colet. 2018;23(9):2821-34. https://doi.org/10.1590/1413-81232018239.17192018 PMID:30281721
Giannouchos TV, Beverly J, Christodoulou I, Callaghan T. Suicide and non-fatal self-injury-related emergency department visits among individuals with autism spectrum disorder. Autism. 2023;27(7):1983-96. https://doi.org/10.1177/13623613221150089 PMID:36700624
South M, Costa AP, McMorris C. Death by Suicide among people with autism: beyond zebrafish. JAMA Netw Open. 2021;4(1):e2034018. https://doi.org/10.1001/jamanetworkopen.2020.34018 PMID:33433593
Hedley D, Uljarevic M, Cai RY, Bury SM, Stokes MA, Evans DW. Domains of the autism phenotype, cognitive control, and rumination as transdiagnostic predictors of DSM-5 suicide risk. PLoS One. 2021;16(1):e0245562. https://doi.org/10.1371/journal.pone.0245562 PMID:33482664 PMCID:PMC7822649
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