Inter-relationships between suicidality and depressive symptoms among children and adolescents experiencing crisis: A network perspective

Suicidality and depressive symptoms have emerged as major mental health issues reported among children and adolescents experiencing crises. In light of these concerns, this study was conducted to elucidate interrelationships between depressive symptoms and suicidality at an item level within this population during the COVID-19 pandemic, a worldwide public health crisis affecting children and adolescents. A cross-sectional study design was used. Primary and secondary school students completed the Children's Depression Inventory – Short Version (CDI-S) and two standard suicidality questions tapping suicidal ideation and suicide plans, respectively. A network analysis was performed to examine inter-connections between depressive symptoms and suicidality. A total of 5380 students participated in the study. Prevalence of suicidal ideation and suicide plans were 12.8 % (95 % CI = 11.9 %–13.7 %) and 9.9 % (95 % CI = 9.2 %–10.8 %), respectively; the prevalence of depressive symptoms was 41.2 % (95%CI = 39.8 %–42.5 %). The network analysis identified CDI4 (self-hatred) as the most influential node with the highest centrality, followed by CDI8 (loneliness), CDI5 (crying), and CDI1 (sadness). Additionally, CDI5 (crying), CDI1 (sadness), CDI4 (self-hatred), and CDI10 (feeling unloved) were the most meaningful nodes linking depressive symptoms with suicidality. Critical depressive symptoms linked with suicidality among children and adolescents living through the COVID-19 pandemic included self-hatred, loneliness, crying, and sadness. Interventions that target these depressive symptoms may have increased utility in reducing the risk of suicidality within this population.