1. Characteristics Associated With Serious Self-Harm Events in Children and Adolescents.
- Author
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Sekmen, Mert, Grijalva, Carlos G., Yuwei Zhu, Williams, Derek J., Feinstein, James A., Stassun, Justine C., Johnson, Jakobi A., Tanguturi, Yasas C., Gay, James C., and Antoon, James W.
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NEUROPSYCHOLOGY , *CONFIDENCE intervals , *SUBSTANCE abuse , *REGRESSION analysis , *DEVELOPMENTAL disabilities , *RISK assessment , *SELF-mutilation in adolescence , *DESCRIPTIVE statistics , *MENTAL depression , *RESEARCH funding , *ODDS ratio , *ANXIETY , *WOUNDS & injuries , *SELF-mutilation , *LONGITUDINAL method - Abstract
OBJECTIVES: To identify patterns of psychiatric comorbidity among children and adolescents with a serious self-harm event. METHODS: We studied children aged 5 to 18 years hospitalized with a neuropsychiatric event at 2 children's hospitals from April 2016 to March 2020. We used Bayesian profile regression to identify distinct clinical profiles of risk for self-harm events from 32 covariates: age, sex, and 30 mental health diagnostic groups. Odds ratios (ORs) and 95% credible intervals (CIs) were calculated compared with a reference profile with the overall baseline risk of the cohort. RESULTS: We included 1098 children hospitalized with a neuropsychiatric event (median age 14 years [interquartile range (IQR) 11-16]). Of these, 406 (37%) were diagnosed with a self-harm event. We identified 4 distinct profiles with varying risk for a self-harm diagnosis. The low-risk profile (median 0.035 [IQR 0.029-0.041]; OR 0.08, 95% CI 0.04-0.15) was composed primarily of children aged 5 to 9 years without a previous psychiatric diagnosis. The moderate-risk profile (median 0.30 [IQR 0.27-0.33]; reference profile) included psychiatric diagnoses without depressive disorders. Older female adolescents with a combination of anxiety, depression, substance, and trauma disorders characterized the high-risk profile (median 0.69 [IQR 0.67-0.70]; OR 5.09, 95% CI 3.11-8.38). Younger males with mood and developmental disorders represented the very high-risk profile (median 0.76 [IQR 0.73-0.79]; OR 7.21, 95% CI 3.69-15.20). CONCLUSIONS: We describe 4 separate profiles of psychiatric comorbidity that can help identify children at elevated risk for a self-harm event and subsequent opportunities for intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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