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Risk factors for suicide attempt in children, adolescents, and young adults hospitalized for mental health disorders.

Authors
  • Ong, Mei-Sing1
  • Lakoma, Matthew1
  • Gees Bhosrekar, Sarah1
  • Hickok, Jason2
  • McLean, Laura3
  • Murphy, Michael4
  • Poland, Russell E1, 3
  • Purtell, Nancy3
  • Ross-Degnan, Dennis1
  • 1 Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
  • 2 Ondine Biomedical Inc, Vancouver, BC, Canada. , (Canada)
  • 3 HCA Healthcare, Nashville, TN, USA.
  • 4 American Addiction Centers, Brentwood, TN, USA.
Type
Published Article
Journal
Child and adolescent mental health
Publication Date
May 01, 2021
Volume
26
Issue
2
Pages
134–142
Identifiers
DOI: 10.1111/camh.12400
PMID: 32569425
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Suicide is a leading cause of death among children, adolescents, and young adults (AYA), and mental health disorders are a major contributing factor. Yet, suicidal behaviors among children and AYA with mental health concerns remain understudied and age-specific risk factors are poorly understood. We examined the risk factors for suicide attempt in children and AYA with mental health disorders across three age groups: pre-adolescent children (aged ≤ 12), adolescents (aged 13-17), and young adults (aged 18-25). A cross-sectional study of children and AYA hospitalized for a mental health disorder (n = 18,018) at a private hospital system with 141 facilities across the United States (year 2014). Suicide attempts six months prior to hospitalization were reported in 12.1% (n = 177) pre-adolescent children, 22% (n = 1476) adolescents, and 17.9% (n = 1766) young adults. Evidence of psychological trauma was present in 55.4% of pre-adolescent children, 51.2% of adolescents, and 44.5% of young adults. Predictors for suicide attempt observed across all three age groups included the following: female sex, depressive disorder, and being a victim of bullying. Risk factors for suicide attempt specific to pre-adolescent children included being uninsured and having an unsafe home or school environment. Among AYA, suicide attempt was associated with non-Hispanic white, family history of suicide, emotional traumas, and other traumatic experiences. Alcohol use disorder was also a significant predictor of suicide attempt in young adults. Suicide attempts among children and AYA admitted to a hospital with mental health concerns are highly prevalent. Socioeconomic stressors appeared to be an important contributing factor of suicidal behavior in pre-adolescent children but not in older AYA. Effective suicide prevention strategies targeting children and AYA would need to consider age-specific risk factors. © 2020 Association for Child and Adolescent Mental Health.

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