Gender differences in the disclosure of suicidal ideation among children and adolescents prior to suicide attempts

Suicide is the leading cause of death among individuals aged 15–19 years, and youth suicide in Japan is increasing. However, few studies have directly confirmed the actual situation of child and adolescent suicide attempters and their parents immediately after the attempts. We investigated whether children and adolescents disclosed suicidal ideation before their attempts through direct interviews with them and their families shortly after emergency department admission. This study was conducted in the Suicide Attempt Registry section of the “Registry Study of Child and Adolescent Mental Health in Japan” in collaboration with the National Kohnodai Medical Center, Japan Institute for Health Security. Patients aged < 18 years who attempted suicide were transported to the Tokai University Hospital Advanced Emergency Medical Center. Psychiatrists interviewed them and their families or guardians about the backgrounds of the attempts, focusing on whether the attempters had disclosed suicidal ideation to anyone. Overall, 76.0% of participants had not consulted anyone before their attempt, and 84.0% of these were male. Additionally, 86.0% of all patients reported being unable to discuss their suicidal ideation with family members beforehand. While these tendencies were more common among males, no statistically significant gender differences were found. In conclusion, children and adolescents who attempted suicide usually faced challenges in disclosing their suicidal ideation to their close circle, particularly family members. These findings were observed regardless of gender. In clinical practice, psychotherapy involving youths and their families is necessary to address youths' reluctance to openly discuss their problems with those close to them.