Annual Trends in Suicide Among Children Under 13 Years in South Korea, 2013-2022: Based on the Intentional Self-Harm (Suicide) Report of Statistics Korea.

Objective: This study examined temporal trends in suicide deaths among South Korean children ≤13 years of age from 2013 to 2022 and identified gender-specific patterns for targeted prevention strategies. Method: We retrospectively analyzed national mortality data from Statistics Korea's microdata, covering the period from 2013 to 2022. Suicide deaths among children ≤13 years of age were analyzed using second-order polynomial regression models and Poisson regression to assess temporal trends and population-adjusted incidence rates. Sex-stratified analyses were performed to examine differences between male and female individuals. Model validation revealed an excellent fit between the observed and predicted rates (correlation = 0.97, mean absolute error = 0.04). Results: Over the 10 years, 79 children ≤13 years of age died by suicide (47 male, 32 female), most commonly by hanging (74.7%). The proportion of children <13 years of age among all suicide deaths in individuals <19 years of age ranged from 1.1% to 3.9% annually, with an increasing trend observed since 2020. Poisson regression showed significant annual increases in suicide incidence for both male (incidence rate ratio [IRR] = 1.09, p=0.045) and females (IRR=1.15, p=0.029). Pre- vs. post-2020 analysis revealed a marked increase in female suicide rates (rate ratio = 2.43, 95% CI = 1.23-4.77), whereas male suicide rates remained stable (rate ratio = 0.71, 95% CI = 0.34-1.46). Conclusion: This study demonstrates divergent suicide trends between sexes in children <13 years, with female children showing a steeper increase over the decade. We should consider suicide prevention and intervention strategies in light of sex differences and social factors in cases of suicide among children. Enhanced surveillance systems and developmentally appropriate interventions are crucial for addressing this emerging public health concern in South Korea's youngest population. Diversity & Inclusion Statement: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.