Knowledge and practices of Paraguayan pediatricians on depression and suicidal ideation in children and adolescents

Abstract

Introduction. Depression and suicidal behavior in children and adolescents represent growing public health concerns. Pediatricians are often the first point of clinical contact; however, limitations in training may hinder early detection and appropriate management. Objective. To explore the knowledge, clinical practices, and perceived barriers among pediatricians in Paraguay regarding the assessment and management of depression and suicidal ideation in children and adolescents. Materials and Methods. An observational, exploratory, cross-sectional study was conducted between April and August 2025 using a structured self-administered questionnaire applied to practicing pediatricians and pediatric residents. Sociodemographic variables, level of knowledge, screening and management practices, and perceived barriers were assessed. Content validity was established through expert review, and internal consistency was adequate (α ≥ 0.75). Descriptive analyses and non-parametric tests were performed. Results. Eighty-two pediatricians participated (mean age 46 ± 11 years; 86.6% female). The mean knowledge score was 3.43/6, and only 28% achieved high levels. Formal training in mental health was absent in 34.1% of participants. Although 75.6% had managed cases involving suicidal ideation or attempts, only 11% frequently assessed depressive symptoms and 29.3% used standardized screening tools. Urgent referral was the predominant response (85.4%). Residency training was significantly associated with higher knowledge scores (p = 0.028). Conclusion. A gap exists between clinical exposure and formal training, limiting systematic detection of suicide risk and highlighting the need to strengthen education and standardize pediatric protocols.