Abstract : OBJECTIVE: Childhood
irritability predicts suicidal ideation/attempt (suicidality), but it
is unclear whether irritability is an independent and direct risk factor
for suicidality or a marker of intermediate mental health symptoms
associated with suicidality. This study aimed to identify developmental
patterns of childhood irritability and to test whether childhood
irritability is directly associated with suicidality or indirectly
associated with intermediate mental health symptoms. METHOD: One
thousand three hundred ninety-three participants from the Quebec
Longitudinal Study of Child Development were followed from birth to 17
years. Teachers assessed irritability yearly (at 6-12 years) and
children self-reported intermediate mental health symptoms (depression,
anxiety, disruptiveness, and hyperactivity-impulsivity; at 13 years) and
suicidality (at 15 and 17 years). RESULTS: Four irritability
trajectories were identified: low (74.7%), rising (13.0%), declining
(7.4%), and persistent (5.0%). Children following a rising irritability
trajectory (versus a low trajectory) were at higher suicidality risk. A
large proportion of this association was direct (odds ratio 2.11, 95% CI
1.30-3.43) and a small proportion was indirect by depressive symptoms
(accounting for 23% of the association; odds ratio 1.17, 95% CI
1.03-1.34). Children on a persistent irritability trajectory (versus a
low trajectory) were at higher risk of suicidality and this association
was uniquely indirect by depressive symptoms (accounting for 73% of the
association; odds ratio 1.51, 95% CI 1.16-1.97). The declining
trajectory was not related to suicidality; no association with anxiety,
disruptiveness, and hyperactivity-impulsivity was found. CONCLUSION:
Rising irritability across childhood represents a direct risk for
suicidality. Persistent irritability appears to be a distal marker of
suicidality acting through more proximal depressive symptoms.
Soumis le : jeudi 9 juillet 2020 - 14:49:03