title: Suicide in pediatrics: epidemiology, risk factors, warning signs and the role of the pediatrician in detecting them.
abstract: Epidemiological data suggests suicide is uncommon in childhood but becomes an extremely serious issue among adolescents.Several risk factors have been identified and include the presence of psychiatric illness, a previous suicide attempt, family factors, substance abuse, sexual and physical abuse, disorders in gender identity or bullying. Pediatricians have a primary role in searching for these risk factors, recognizing them and acting synergistically with other specialists to prevent and treat suicidal behavior.Pediatricians should also be able to identify the "warning signs" for suicide since their presence implies a need for immediate action, as attempted suicide may occur in a few hours or days.The use of antidepressant drugs and its association with suicidal risk in pediatric age is another topic of ongoing debate. Food and Drug Administration has recently introduced the so-called "black box" on antidepressants' packages with the aim of gaining attention to the possible risk of suicide among adolescents who are treated with antidepressants, with a warning that the risk of suicide is higher when starting a therapy or while adjusting its dosage.
authors.affiliation: Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy. dario.dilillo@icp.mi.it.
authors.forename: Dario
authors.initials: D
authors.lastname: Dilillo
authors.affiliation: Department of Pediatrics, Luigi Sacco Hospital, University of Milan, Milan, Italy. mauri.silvia@hsacco.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Mauri
authors.affiliation: Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy. cecimante@hotmail.com.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Mantegazza
authors.affiliation: Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy. valentina.fabiano@unimi.it.
authors.forename: Valentina
authors.initials: V
authors.lastname: Fabiano
authors.affiliation: Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy. chiara.mameli@unimi.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mameli
authors.affiliation: Department of Pediatrics, Ospedale dei Bambini V. Buzzi, University of Milan, Milan, Italy. gianvincenzo.zuccotti@unimi.it.
authors.forename: Gian Vincenzo
authors.initials: GV
authors.lastname: Zuccotti
mesh_terms: D002648:Child; D014943:Global Health; D006801:Humans; D010372:Pediatrics / Q000379:methods*; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data; D000092864:Suicide Prevention