Suicide risk in adolescents with Intellectual Disability, Language Disorder, and Specific Learning Disorder
Irene Di Modica, Arianna Accetta, Federica Galletta, Carola Costanza, Eva Germanò, Antonella Gagliano
Suicidal spectrum behaviours (SSB) include a continuum ranging from suicidal ideation, non-suicidal self-harm (NSSI), and suicide attempt (SA), up to death by suicide. Suicide in the pediatric population has a higher prevalence among adolescents diagnosed with NDDs (neurodevelopmental disorders), predominantly in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), and in patients with psychiatric disorders, especially in the presence of psychotic symptoms, depression and anxiety disorders. Although the literature has focused more on children and adolescents with ADHD, ASD and Tourette’s syndrome, a real risk has also emerged for patients with intellectual disabilities, communication disorders and specific learning disorders. Through a narrative review of the literature, we aim to focus attention on suicidal spectrum behaviours in these latter neurodevelopmental disorders, placing the focus on risk factors, screening possibilities and therapeutic approaches. Available data from literature suggest that emotion dysregulation should be considered the main factor related to SSB. Among the universal screening tools, the most valid are the Child Behaviour Checklist (CBCL)-Dysregulation Profile (DP) questionnaires and the Difficulties in Emotion Regulation Scale (DERS). As for the treatment, the most relevant psychotherapeutic approaches are «Integrated Cognitive-Behavioural Therapy (I-CBT)», «Multisystemic Therapy (MST)», «Mentality-Based Treatment for Adolescents (MBT-A)», «Developmental Group Psychotherapy (DGP)», «Parent and Adolescent Programme (RAP-P)», and «Dialectical Behaviour Therapy for Adolescents (DBT-A)». Among psychopharmacological treatments, antidepressants and mood stabilizers are the most commonly used, specifically we will take into consideration treatment with lithium and selective serotonin reuptake inhibitors (SSRIs).
Keywords
Suicide, Neurodevelopmental disorders (NDDs), Pediatric population, Emotional dysregulation, Adverse childhood experiences (ACEs).
