Symptomatic depression and suicidal ideation. A comparative study with 628 children.

A comparison was made of demographic and clinical variables between 481 children aged 15 or less who exhibited symptomatic depression and 147 children who had this symptom and who also had suicidal ideas. Suicidal ideation was associated with disturbed, hostile intrafamilial relationships. It was also associated with age in girls. Significantly, experiences of loss were associated with symptomatic depression rather than with suicidal ideation per se. No specific psychiatric, emotional, or conduct disorder symptoms were found to differentiate between the two groups. Similarly, extrafamilial and social characteristics were not differentiating features. The children with suicidal ideation had no more disturbance of peer relationships or social withdrawal than did their nonsuicidal depressed counterparts and may not, therefore, be readily identifiable by teachers or other responsible adults. Clinical management of potentially suicidal children needs to encompass symptomatic treatment of depression and amelioration of adverse family interactions.