Tuesday, October 26, 2021

Understanding the early-life origins of suicide: Vulnerability may start even before birth

Suicide is a sad event. Unfortunately, every 40 seconds a person dies by suicide. More than 100 people may be affected by each suicide, including family, friends and community members, beyond the premature loss of a person’s life.

People contemplating their death have often gone through long periods of intense pain and internal struggles. They may have endured mental illness and experienced many adverse life events. That’s why helping people with mental disorders and/or going through difficult times is extremely important to prevent suicide.

However, evidence from research conducted over the past two decades has highlighted that suicide is not simply the result of such contributing factors around the time of death. Instead, susceptibility to suicide may build up over a lifetime. It can be triggered by events that occur very early in life, in the perinatal period and infancy, which have a long-lasting effect on suicide in adulthood.

Developmental origins of health and diseases

In the 1990s, British epidemiologist David Barker observed that children with low birth weight (less than 2.5 kg) or premature (before 37 weeks) developed chronic conditions such as heart or metabolic diseases as adults. was more likely to happen. These observations served as the foundation for the evolution of the health and diseases (or DOHAD) hypothesis.

The DOHAD hypothesis suggests that exposure to environmental influences during the critical period of fetal development can have significant consequences on an individual’s short-term and long-term health. This knowledge promoted early life interventions such as prenatal and infant nutrition to improve long-term outcomes. It also supported guidelines to promote quality care before, during, and during pregnancy.

As such, the DOHaD hypothesis has increased scientific interest in understanding how early life events affect the risk of other health problems, including suicide.

Early life origins of suicide

When the fetus is exposed to adverse conditions, it can adapt to survive in the harsh environment in utero.

As researchers from the LIFESPAN research project, we aim to better understand whether early life factors influence suicide risk later in life, and how. If early life factors are associated with suicide, suicide prevention strategies need to be implemented early in life.

Within the LIFESPAN project, we recently conducted a meta-analysis looking at 42 articles from 21 longitudinal cohort studies from Europe, North America, South America and Asia. It examined the associations of 14 early life factors in the prenatal and prenatal periods – including low birth weight, obstetric complications, the family’s socio-economic status at the time of birth, and the age of the young parent. Later with suicide.

Of the 14 factors examined, seven were associated with suicide in adulthood, providing support for the DOHAD hypothesis. The strongest early life effects on later suicide were restricted fetal growth including low parental education, low family socio-economic status and young maternal age, as well as low birth weight.

For example, researchers found that babies born with low birth weight or premature birth were more likely to die by suicide than babies with normal birth weights. They also found that children of adolescent parents were more likely to die by suicide than children of older parents, and that children born to parents with a lower level of education were more likely to die by suicide than those born to parents with a higher level of education. Children born to fathers were more likely to die by suicide than children.

It is important to note that these are epidemiological findings that should not be applied directly to an individual, but should be applied to a population. We may not consider a child born prematurely to be at increased risk of suicide, but in a given population, babies born prematurely have a higher average risk of dying by suicide than babies born prematurely. Is.

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How early life risk factors increase the risk of suicide

Illustration of silhouette of a person in sad posture
If early life factors are associated with suicide, suicide prevention strategies need to be implemented early in life.

An important follow-up question is to understand that factors that occur very early in life can influence behavior that occurs decades later. The first principle refers to the social system. Socio-economic factors (such as poverty or low education levels) are major determinants of health and are transmitted from generation to generation.

Children born into families with little financial resources may have limited access to quality education, health care and life opportunities. This can increase the likelihood of experiencing financial and social problems in adulthood, which in turn can increase the risk of suicide. In other words, the social and economic problems that increase the risk of suicide in adulthood may, in part, be a continuation of the socioeconomic conditions of the family in which a child was born.

This is also true for non-monetary indicators of socio-economic status such as parental education. Parents who are young and less educated may not have the physical and emotional resources to provide their children with the best start in life. Therefore providing resources to young parents from low socio-economic circumstances may be an opportunity to improve their child’s health into adulthood, and consequently reduce the risk of suicide.

illustration of a blue human silhouette with clouds and rain in the head
The ability to cope with the stresses of life, also known as resilience, is a major protective factor for suicide and mental health problems in general.

A second theory refers to the development of the brain. The DOHAD hypothesis states that when the fetus is exposed to adverse conditions, it responds with adaptations to survive the harsh environment in utero. These adaptations can result in impairments in brain development, which in turn are associated with decreased cognitive skills that can further reduce a person’s ability to cope with stressful events later in life. The ability to cope with the stresses of life, also known as resilience, is a major protective factor for suicide and mental health problems in general.

Reducing the risk factors that determine low birth weight or fetal distress, such as poor nutrition, infection, exposure to chemicals or hormonal disturbances, is important for the health of the offspring. However, interventions to increase resilience in children who experience adversity during the fetal period may be a promising avenue to prevent subsequent problems, including suicide.

Suicide prevention from an early life perspective

Early prevention is universally recognized to reduce health problems while minimizing societal costs. Early prevention often means removing or reducing risk factors in a population before a health problem appears.

In this perspective, research on the early-life origins of suicide invites us to integrate intervention at the individual level with prevention at the population level. This supports the need to think about suicide prevention as a long-term, not uniquely short-term, effort with the goal of reducing susceptibility to suicide over the course of life.

Public health policy that provides the best environment for children to grow up may have the potential to build resilience and reduce long-term vulnerability to suicide.

If you or someone you know is thinking about suicide, call 911 for emergency services. For assistance, call the Canada Suicide Prevention Service at 1-866-277-3553 (from Quebec) or 1-833-456-4566 (other provinces), or send a text to 45645. For more resources visit Crisis Services Canada.

This article is republished from – The Conversation – Read the – original article.

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