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Eur Child Adolesc Psychiatry. 2008 Dec;17 Suppl 1:92-8. doi: 10.1007/s00787-008-1010-3.

Self-mutilation and suicidal behaviour in children and adolescents: prevalence and psychosocial correlates: results of the BELLA study.

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  • 1Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany. franz.resch@med.uni-heidelberg.de



To investigate the prevalence and psychosocial correlates of suicidal behaviour in a representative sample of children and adolescents in Germany.


Suicidal behaviour was assessed in the BELLA study in a sample of 2,863 families with children aged 7-17 using the corresponding questions from the child behavior check list and the youth self report. Self-reported as well as parent-reported measures of overall mental health problems, anxiety, depression, aggressive and delinquent behaviour, attention deficit-/hyperactivity as well as health-related quality of life were also administered.


Self-mutilation and/or suicidal attempts within the last six months were reported by 2.9% of the adolescents 11-17 years of age. Suicidal thoughts were reported by 3.8% of the same group of adolescents. The prevalence rates reported by the parents were 1.4% for self-mutilation and/or suicidal attempts and 2.2% for suicidal thoughts. The prevalence of parent-reported self-mutilation/suicidal attempts in children below 11 years of age was very low. Youth reporting suicidal behaviour were older than youth not reporting suicidal behaviour. Children and adolescents exhibiting suicidal behaviour reported significantly more general mental health problems, depressive symptoms, anxiety, and hyperactivity as well as lower health-related quality of life.


There is a strong connection between suicidal behaviour and emotional and behavioural problems, especially with symptoms of depression, anxiety and hyperactivity. The association observed between attention deficit-/hyperactivity and suicidal behaviour requires further investigation. The differences in the extent of reported suicidal behaviour in adolescents between the self- and parent-ratings and the degree of confidentiality in the collection of the data are subjects for future research.

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