Suicidal behavior among individuals with trisomy 21: an integrative review

Trisomy 21 (T21) is a genetically determined human condition that occurs in one in every 800 births worldwide. Improvements in lifelong care have generated discussion about the mental health of people with T21. However, suicidal behavior in this population has still received little attention. This integrative review aimed to understand and synthesize scientific production on the topic of 'suicide in people with T21'. We conducted the review in the Virtual Health Library, PubMed, and PsycInfo databases using the descriptors 'Down syndrome', 'Down's syndrome', and 'trisomy 21' in combination with 'suicide', 'suicide attempted', and 'suicidal ideation'. We analyzed articles published until 10^th October 2023. The selected articles were evaluated for their level of evidence and categorized thematically. Eight articles from three countries met the eligibility criteria: three case reports, three narrative literature reviews, one observational cross-sectional study, and one cohort study. The articles were organized and discussed in four categories: (1) scientific literature impressions about suicide in individuals with T21; (2) T21 life course issues and forms of expression of suicidal behavior; (3) suicide frequency in individuals with T21; and (4) possible implications for caring for individuals with T21 who exhibit suicidal behavior. The results revealed a lack of literature on the subject, which indicates the need for additional research. Based on the evidence available, suicidal behavior among people with T21, while a possible phenomenon, seems uncommon. Health professionals should investigate T21 individuals' mental health, searching for depression and self-injury symptoms.