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Older Teens, Asians, at Highest Risk of Self-Harm

*The following is excerpted from an online article from the Medpage Today.

Older teenagers, Asians, females, and those with existing mental disorders had the highest risk among adolescents of incurring a self-inflicted injury (SII), according to a population-based longitudinal study of emergency department data.

Increased risk of SII was found among adolescents ages 15-18, Asian race, adolescents with comorbid conditions, and females, reported Gretchen J. Cutler, PhD, of Children's Hospitals and Clinics of Minnesota, and colleagues.

However, African American adolescents had a lower risk of SII compared with white and Asian adolescents, they wrote in Pediatrics.

But any adolescent with a SII had a much higher risk of death than adolescents with other injuries. The highest risk was found among males, teenagers 15-18, white race, and those who self-paid for treatment.

Trends varied by demographic group. Cut/pierce was the most common injury in both adolescents ages 10-14 and 15-18, but the younger group was more likely to be associated with suffocation than the older group. While female adolescents were more likely to be seen for cut/pierce injuries, males were more likely to be seen for firearm injuries.

Adolescents with public or self-pay insurance had a greater risk of SII compared to those with private insurance. Both alcoholism and obesity were also had linked to an increased risk of SII.

"I think knowing some subgroups that are more at risk can help in primary prevention," she said. "We should increase the use of screening tools in primary care for suicidal thoughts and make sure when these kids come into the ED, they're getting good care and they're getting connected to resources once they leave so that we can reduce the likelihood they're going to come back," said Cutler in a separate interview with MedPage Today.

Those adolescents with an SII were more likely to have high injury severity, less likely to be discharged from the ED, and more likely to die in the ED than their non-SII counterparts. A greater portion of adolescents with SII were associated with alcoholism and obesity.

Researchers examined data from the National Trauma Data Bank (NTDB) for patients 10 to 18 years of age who were treated in the ED for a SII. Of those, 71.6% were male, 58.8% were white, 60.3% were ages 15-18, 85.8% had no comorbidities, and 17.8% were not severely injured. In addition, 4.9% of these adolescents were diagnosed with any mental disorder, with 47.2% of those diagnoses being depressive disorders.

Source: Medpage Today
http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/52127