Neurodevelopmental Disorder Documentation Among U.S. Adolescents Who Died by Suicide: A National Analysis of CDC WONDER Mortality Data, 2018–2024
Year: 2026
Type: preprint
Abstract: Background Neurodevelopmental disorders (NDDs), including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID), are associated with increased suicidality during adolescence. However, little is known about their representation in mortality records of adolescents who die by suicide. This study examined the frequency, demographic distribution, and temporal patterns of documented psychiatric and neurodevelopmental conditions among U.S. adolescents who died by suicide from 2018–2024. Methods We conducted a retrospective population-based analysis of 2018–2024 Multiple Cause of Death data from the CDC WONDER database. Suicide deaths among U.S. adolescents aged 10–19 years were identified using ICD-10 codes X60–X84 and Y87.0. Multiple-cause fields were queried for mental and behavioral disorders (F01–F99) and specifically ADHD (F90), ASD (F84), and ID (F70–F79). Demographic differences were assessed using chi-square tests, and Poisson regression was used to evaluate temporal trends. Suppressed cells (< 10 deaths) were excluded from corresponding subgroup analyses. Results Among 19,369 adolescent suicide deaths, 1,226 (6.33%, 95% CI [5.99%–6.68%]) had a documented mental or behavioral disorder. ADHD was documented in 52 deaths (0.27%, 95% CI [0.20%–0.35%]), ASD in 18 (0.09%, 95% CI [0.06%–0.15%]), and ID was documented in 0 deaths. Documentation of mental or behavioral disorders was higher among adolescents aged 15–19 than those aged 10–14 years (6.68% vs. 4.88%), females than males (8.14% vs. 5.66%), White than Black adolescents (6.88% vs. 3.46%), and non-Hispanic than Hispanic adolescents (6.80% vs. 4.71%; all p < .001). Annual documentation ranged from 5.71% to 6.93%, with no significant variation across years (p = .451). NDD documentation remained sparse throughout the study period. Conclusions Among nearly 20,000 U.S. adolescent suicide deaths, mental and behavioral disorders were documented on the mortality record in approximately 1 in 16 deaths, while ADHD and ASD were documented in fewer than 1% and ID in 0 deaths. These findings should not be interpreted as estimates of the prevalence of NDDs among suicide decedents, but rather as evidence of limited NDD ascertainment in mortality records. The persistent documentation gap and observed demographic differences highlight an important limitation of mortality-based surveillance. Incorporating developmental and psychiatric histories into death investigations and linking mortality records with clinical data may improve NDD ascertainment and strengthen suicide surveillance and prevention for neurodivergent youth.
Source: Research Square
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7225611945