Clinical characteristics and risk factors of early-onset schizophrenia in children with self-injurious suicide behavior

Abstract

Objective

To understand the clinical characteristics and risk factors of early-onset schizophrenia in children with self-injurious suicide behavior.

Methods

From March 2021 to December 2021, the clinical information of 77 inpatients with demography characteristics, family characteristics, and diseases which met the ICD-10 diagnostic criteria for “schizophrenia” in the pediatric wards of Shanghai Mental Health Center was retrospectively collected. According to whether or not there was self-injurious suicide behavior, they were divided into the self-harm and suicidal behavior group (self-harm and suicidal behavior - S) and the non-self-injurious suicide group (NS); inter-group comparison and regression analysis was performed between the two groups.

Result

There were 51 cases (66.2%) of early-onset childhood schizophrenia patients with self-injurious suicidal behavior, verbal auditory hallucinations (94.12%) and delusion of reference (92.16%) being the main psychological symptoms. Compared with early-onset schizophrenia patients without self-injurious suicidal behavior, early-onset schizophrenia patients with self-injurious suicidal behavior had a higher incidence of delusion of reference (t = 3.184, P = 0.002) and command auditory hallucinations (t = 2.256, P = 0.027). The Eysenck Personality Questionnaire showed that the score of neuroticism was higher (F = 4.139, P = 0.001); the level of free tetraiodothyronine (FT4) was lower (t = –4.436, P < 0.001); and logistic regression analysis showed that gender (P = 0.036, OR = 14.863), FT4 (P = 0.011, OR = 0.607) and neuroticism score (P = 0.035, OR = 1.073) were related to the occurrence of self-injurious suicide in children with early-onset schizophrenia.

Conclusion

Early-onset schizophrenia patients with self-injurious and suicidal behavior have typical psychiatric symptoms, accompanied by some characteristics associated with emotional instability. Females with low levels of FT4 and neuroticism have risk factors for suicide with self-injury in early-onset schizophrenia.