The developmental origins of suicide mortality

Eunice Kennedy Shriver National Institute Of Child Health & Human Development

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Abstract

The overarching objective of this study is to ascertain the vital status and cause-specific mortality of children born to participants in the Collaborative Perinatal Project (CPP) in order to investigate domains of vulnerability to suicide that are hypothesized to be established in early childhood. This will be accomplished by linking existing data in the NICHD-CPP cohort to the National Death Index (NCHS - National Center for Health Statistics). Suicide rates are rising, from 10.43/100,000 in 2000 to 13.02/100,000 in 2013. In 2013, suicide was the third leading cause of death among children ages 10-14 years and the second leading cause of death between ages 15 and 24. Suicide accounts for 800,000 years of potential life lost annually. In addition to an economic impact exceeding $40 billion per year, it has devastating personal impacts on survivors as well as the general public. Although numerous risk factors have been identified, including prior attempts, traumatic or stressful life events, and sociodemographic, psychiatric, psychological, biological and family, and socioeconomic characteristics, accurate prediction of suicide remains elusive even in high-risk groups. To date, epidemiologic studies of suicide have largely focused on proximal risk factors and developmental stages beyond the initial formation of vulnerability, despite growing evidence that frames psychiatric disorders as neurodevelopmental disorders. Evidence is also increasing that adolescent and adult precipitants of suicide have roots in early childhood. Study population: The study population consists of 52,966 children born to women who enrolled in the CPP and known to be alive at age 7 years. The CPP involved the systematic and extensive observation and examination of 58,760 pregnancies, including collection of blood samples collected at the first and subsequent prenatal visits, and follow-up assessments of offspring through the first 7 years of life. National follow-up rates for surviving offspring (96.7% of study births at age 7 years) were 88% at year 1, 75% at year 4, and 79% at year 7. Design: This study consists of secondary analyses in which CPP offspring data will be linked to the National Death Index to determine vital status and cause(s) of death. Results of the NDI linkage will be anonymized and then merged with existing CPP data for statistical analyses. Accomplishments during FY17: During FY17, the data abstration from original CPP records was completed and transferred via encrypted files to NICHD Investigators. Quality control of the data abstraction began, and the data are in prepration for submission to the National Death Index.