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Abstract Objective In the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa. Method We used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84). We additionally constructed a suicide index to distinguish between the two causes of death. Results The young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain. Conclusion In line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling.

Abstract Background The purpose of this study was to gain knowledge about the circumstances related to suicide among children and adolescents 15 years and younger. Methods We conducted a psychological autopsy, collecting information from parents, hospital records and police reports on persons below the age of 16 who had committed suicide in Norway during a 12-year period (1993-2004) (n = 41). Those who committed suicide were compared with children and adolescents who were killed in accidents during the same time period (n = 43) and with a community sample. Results: Among the suicides 25% met the criteria for a psychiatric diagnosis and 30% had depressive symptoms at the time of death. Furthermore, 60% of the parents of the suicide victims reported the child experienced some kind of stressful conflict prior to death, whereas only 12% of the parents of the accident victims reported such conflicts. Conclusion One in four suicide victims fulfilled the criteria for a psychiatric diagnosis. The level of sub-threshold depression and of stressful conflict experienced by youths who committed suicide did not appear to differ substantially from that of their peers, and therefore did not raise sufficient concern for referral to professional help.

Abstract Background Few population-based samples have previously published performance on the Ages and Stages Questionnaire (ASQ), a recommended screening tool to detect infant developmental delay. The aim of the study was to investigate performance on the ASQ in a population-based sample of 6-month-old infants. Methods In this population-based questionnaire study from Oslo, Norway, the 30 item ASQ 6 month Questionnaire (N = 1053) were included, however without the pictograms, and compared to the Norwegian reference sample (N.ref) (N = 169) and to US cut-off values. Exclusion criteria were maternal non-Scandinavian ethnicity, infant age < 5.0 or > 7.0 months (corrected age), twins, and birth weight < 2.5 kg. Cut-off = 2.5 percentile (equivalent to mean minus 2 standard deviations). Pearson's Chi square and Mann-Whitney U were used to compare items and areas, respectively, with N.ref. Results The reported ASQ scores were lower on all but one of the 10 significantly different items, and in all areas except Personal social, compared to the N.ref sample. The estimated cut-off values for suspected developmental delay (Communication 25, Gross motor 15, Fine motor 18, Problem solving 25 and Personal social 20) were lower than the recommended American (US) values in all areas, and lower than the Norwegian values in two areas. Scores indicating need for further assessment were reached by 13.8% or 20.5% of the infants (missing items scored according to the US or the Norwegian manual), and by 33.8% or 30.3% of the infants using the recommended US or the Norwegian cut-off values, in this population-based sample. The Fine motor area demonstrated a large variability depending on the different cut-off and scoring possibilities. Both among the items excluding pictograms and the items that do not have pictograms, approximately every third item differed significantly compared to the N.ref sample. Conclusion The psychomotor developmental scores were lower than in the reference samples in this study of ASQ 6 month Questionnaire; to our knowledge the first study to be both representative and comparatively large. Approximately every third child with birth weight above 2.5 kg, received scores suggesting further assessment using recommended ASQ cut-off scores.

The article presents research which examined suicide notes of patients aged 15 and below. Topics covered include the characteristics of the notes and the importance of detecting causes of suicide. Also mentioned is the content of the notes, the prevalence of mental disorders among suicide victims, and possible relation between openness and personality traits.

Executive deficits are reported in both early onset bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD), and controversies regarding comorbidity and symptom overlap have complicated the research on executive function in BD. Reports of the negative impact of executive difficulties on academic functioning indicate a need for a greater focus on executive difficulties in early onset psychiatric disorders. Executive function and processing speed in youths with BD (n = 4), ADHD (n = 26) and BD + ADHD (n = 13) were compared with controls (n = 69). All clinical groups demonstrated executive impairment. The combined group was most impaired. There were no significant differences between the groups. Executive deficit in the BD group was associated with a history of psychotic symptoms. The BD-nonpsychotic group was impaired only with regard to processing speed. Processing speed adjustment improved working memory and normalized interference control in both BD and ADHD. Conclusion: executive deficits in BD may be determined by a history of psychotic symptoms rather than by comorbid ADHD. Some aspects of executive problems appear speed-related. [ABSTRACT FROM PUBLISHER]

Antidepressants may increase suicidal behaviour in children and adolescents with depression, and should be used with great care. The article provides an overview of research that may guide the clinician when treating depression in young people. No medication should be given without a thorough evaluation of diagnoses and psychosocial problems. Psychoeducation and psychotherapy should be tried before medication is started. Fluoxetine is the first choice for depression. If it is not effective, a switch to another SSRI may prove effective. SSRIs are found to be more efficacious in adolescents than in children.

Background: The article highlights how environmental factors early in life, in combination with genetic vulnerability, can influence development and partly explain variations in mental health., Material and Method: A selection of key articles identified on Medline., Result: The plasticity of a child's brain makes it particularly susceptible to environmental factors. This provides a significant potential for learning and adaptation, but also causes vulnerability with respect to, for instance, mental illness. There are no studies showing that a specific trauma or strain causes a specific psychological disorder later in life. Nonetheless, recent studies show that certain environmental factors in early life could have a lasting impact on a child's psychosocial behaviour. The article sums up some of these findings., Conclusion: Early preventive measures are particularly important in cases where a biological vulnerability occurs. It is equally important to have realistic expectations with respect to the results of the various measures. Not everything can be returned to normalcy, though it is always possible to promote a development potential.

Background: Bipolar disorders often develop in children and adolescents but are seldom diagnosed before adulthood. These illnesses are associated with considerable morbidity and mortality. The aim of this paper is to provide knowledge to facilitate earlier diagnosis., Material and Method: Medline search., Results: Bipolar disorders are characterised by serious fluctuations in energy and mood. The diagnosis of bipolar disorders in children and adolescents is challenging because the clinical presentation is influenced by ongoing neural development, which cause considerable symptom overlap and comorbidity with ADHD, conduct disorders, anxiety and Tourette's syndrome. ADHD symptoms may be a precursor of bipolar disorder among some of the youngest children, and prepubertal depression is often pre-bipolar.

Background: Over the past decades, suicidal behaviour has increased among adolescents. We wanted to explore what characterises adolescents who come in to see a general practitioner prior to a suicide attempt., Material and Method: 87 % of a group of adolescents below the age of 20 (N = 92) who were admitted to hospital after attempted suicide were interviewed and compared to a non-suicidal control group., Results: 41 out of the 92 saw a doctor within six weeks prior to the attempt; 27 presented with purely physical problems, 6 with psychological problems and eight with a combination of both. Only 2 brought up suicidal thoughts with their doctors. Those who saw a doctor prior to the suicide attempt were older and more frequently had eating disorders than those who did not. No other significant differences were found. Compared to the control group, suicidal adolescents who came in to see a general practitioner more often reported divorced parents, fewer siblings, little support from family and peers, having sex at an early age, frequent use of tobacco and illegal drugs, low self-esteem, loneliness and depressive symptoms (p < 0.01)., Interpretation: Adolescents who saw a doctor prior to a suicide attempt differed significantly from the non-suicidal controls. General practitioners need to have extensive knowledge about risk factors in order to recognise suicidal adolescents. Active inquiry about psychosocial problems, psychopathology and suicidal ideation is necessary.