This narrative review examined biological signatures related to suicidal ideation, suicide attempts, and death by suicide. The authors compared data from pediatric and adolescent populations against adult findings. The study was not a clinical trial but a review of existing information.
The analysis found that biological markers for these outcomes are only partially distinct rather than lying on a single continuum of severity. Specifically, cortisol regulation and stress-related DNA methylation differed in direction between the pediatric and adult cohorts. The review concluded that the biological processes underlying pediatric suicidal behavior are developmentally distinct.
Because these processes are different, findings from adult studies cannot be directly extrapolated to youth. The authors note that pediatric-specific evidence remains limited and the extent to which adult data applies to children is unclear. Advancing this field will require longitudinal, multimodal pediatric studies that span the pubertal transition and apply age-stratified reference ranges. Readers should understand that current adult biomarker data cannot explain youth risks.
