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"It Would have been Better if I had Never been Born" - Suicidality in Early Childhood Depressive Disorders and its Association with Externalizing Symptoms Empirical evidence on suicidality in early childhood (< 9 years) and on the role of comorbid externalizing symptoms in depressive disorders remains limited. We aimed to examine how externalizing symptoms, as assessed by multiple informants, are associated with suicidality in young children with depression. In a clinical help-seeking sample of 61 children (3-8 years) with depressive disorders, suicidality was assessed using a clinical interview (Preschool Age Psychiatric Assessment, PAPA) with the primary caregiver. Externalizing symptoms were assessed via child report (Berkeley Puppet Interview), parent report (Child Behavior Checklist 4-18), and (kindergarten) teacher report (Teacher Report Form 5-18). Criteria for suicidality (PAPA) were met by 39.3 % of the children. Suicidal ideation was reported for 21.3 %, suicide attempts for 3.3 %, and no child exhibited a suicide plan. In multiple regression analyses controlling for sociodemographic variables and child and parental depressive symptoms, higher levels of externalizing symptoms reported by the child and the mother were significantly associated with suicidality. The findings indicate that suicidality is a frequent phenomenon in early childhood depression and is associated with comorbid externalizing symptoms. To clarify the meaning of suicidal statements in early childhood, an individual case-based approach is required, as illustrated by a case study.