Frequent Moves Linked to Childhood Suicide

6-3-2009 Global:

SAN FRANCISCO, June 2 -- When a family relocates frequently, the children may be put at increased risk of suicidality, according to a Danish study.

The risk for both attempted and completed suicide doubled among kids age 11 to 17 after three to five changes of residence, Ping Qin, Ph.D., M.D., of the University of Aarhus in Aarhus, Denmark, and colleagues found.

With more than six moves, the risk at least tripled, in an apparent "dose" response manner in the longitudinal, population-based study reported in the June issue of the Archives of General Psychiatry.

Teens and tweens are particularly sensitive to life's changes, "especially those changes beyond one's own choice and will," that disrupt their familiar environment and disrupt their social network, the researchers noted.

Distress and difficulty coping with the change can lead to suicidal behavior as a last-resort response, they said.

"Parents, caretakers, and schools should be aware of the psychosocial needs of children who have recently moved and be ready to help them resolve their distress together or through professional assistance," Dr. Qin's group recommended.

The researchers analyzed data from four national databases in Denmark -- the civil, hospital, cause of death, and psychiatric registers -- for children ages 11 to 17.

Because all Danes are required to report changes of permanent residence within five days, the researchers examined the number of moves for 4,160 adolescents who had their first visit to Danish general hospitals because of a suicide attempt between 1995 and 2006.

Matching each of these cases to 30 controls of the same age and sex revealed more frequent relocation among suicidal adolescents.

More than three moves occurred for 55.2% of suicidal children compared with 32.0% of controls, and 7.4% of suicidal children had moved more than 10 times compared with 1.9% of controls.

Even after adjustment for birth order, birthplace, whether the father was around, and parental age at birth, the risk of suicide attempts in the cohort compared with no moves was

•44% elevated after one or two moves (95% confidence interval 31% to 59%)
•2.31-fold higher after three to five moves (95% CI 2.08 to 2.55)
•4.01 times higher after six to 10 moves (95% CI 3.58 to 4.49)
•5.69-fold higher after 11 to 15 moves (95% CI 4.82 to 6.72)
•7.17 times elevated after more than 15 moves (95% CI 5.56 to 9.24)

Suicide completion, although less common at 79 cases over the same period, generally showed the same pattern of rising incidence rate ratios with more frequent relocation compared with no moves, as follows:

•1.02 for one or two moves (95% CI 0.51 to 2.04)
•2.28 for three to five moves (95% CI 1.13 to 4.59)
•3.56 for six to 10 relocations (95% CI 1.62 to 7.82)
•3.28 for more than 10 moves (95% CI 1.03 to 10.51)

Boys and girls appeared to be affected to the same degree regardless of age at moving, but additional adjustment for their own psychiatric morbidity, loss of a parent, and parental psychiatric histories attenuated the effect somewhat for both suicide attempts and completion.

The researchers cautioned that their study included only children who visited general hospitals for a reported reason of "attempting suicide," so those with severe suicidal ideation or suicide attempts that did not lead to a hospital contact and those with a different reported reason would have been missed.

Also, the observational data could not determine causality, they noted.

Regardless of the reason for the link between relocation and suicidality, Dr. Qin's group said these findings underscore the need for stability in children's lives.

A move can increase hardship and stress on parents and reduce the attention they give to their children, making children feel ignored and without anyone with whom to communicate, they said.

Parents may be able to minimize the adverse effect of moving frequently by involving children in the process and promptly re-establishing the normal family routine and schooling, the researchers suggested. ..Source.. by Crystal Phend, Staff Writer, MedPage Today