Children with depressive, anxious, and irritable temperaments have twice the risk for developing suicidal personalities or attempting suicide compared with children with decreased frequency of either depressive/anxious moods or low irritability, according to a study published in JAMA Psychiatry.

Massimiliano Orri, PhD, of the Bordeaux Population Health Research Centre at the Institut National de la Santé et de la Recherche Medicale and the University of Bordeaux in France, and associates conducted a population-based group analysis to assess the correlation between ranging degrees of irritability and depressive/anxious moods in childhood and adolescent suicide.

The study included 1430 participants (52.7% girls, 47.3% boys) aged 6 to 12 at baseline, monitored until age 17. Mood profiles were recorded annually or biannually until study subjects reached age 12, at which time older participants were asked to self-report suicidality at ages 13, 15, and 17 (primary outcome).

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Of the 1430 individuals, 58.1% experienced a combination of no irritability and low depressive/anxious moods or low levels of both irritability and depressive/anxious moods. High levels of depressive/anxious moods only were reported in 6.6% of participants; high levels of both irritability and depressive/anxious moods were recorded in 10.6%.

Increased rates of suicidality were more evident among adolescents that experienced high levels of both variables as children (16.4%) compared with those who only experienced the lowest levels of symptoms (11.0%).

The investigators reported a correlation between high negative moods and suicidality (odds ratio [OR], 2.22; OR, 3.07 among female subjects only).  Lower levels of combined negative moods were associated with suicidality as well (OR, 1.51); this association was not seen with high levels of depressive/anxious moods only (OR, 0.96). High irritability and high depressive/anxious moods were more closely associated with suicidality than high depressive/anxious moods alone (OR, 2.28).

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“Children with high irritability and depressive/anxious mood and, to a lesser extent, with moderate irritability only had a higher suicidal risk during adolescence compared with children with low symptom levels,” the authors noted.

“Early manifestation of chronic irritability during childhood, especially when combined with depressive/anxious mood, may be associated with an elevated risk for adolescent suicidality,” the researchers continued. “The putatively causal role of irritability should be investigated.”


Orri M, Galera C, Turecki G, et al. Association of childhood irritability and depressive/anxious mood profiles with adolescent suicidal ideation and attempts. [published online March 28, 2018]. JAMA Psychiatry. doi: 10.1001/jamapsychiatry.2018.0174