@article{ref1,
title="Predictors of self-harm emergency department visits in adolescents: a statewide longitudinal study",
journal="General hospital psychiatry",
year="2018",
author="Goldman-Mellor, Sidra and Kwan, Kevin and Boyajian, Jonathan and Gruenewald, Paul and Brown, Paul and Wiebe, Deborah and Cerdá, Magdalena",
volume="56",
number="",
pages="28-35",
abstract="OBJECTIVE: This study investigated patient- and area-level characteristics associated with adolescent emergency department (ED) patients' risk of subsequent ED visits for self-harm. <br><br>METHOD: Retrospective analysis of adolescent patients presenting to a California ED in 2010 (n = 480,706) was conducted using statewide, all-payer, individually linkable administrative data. We examined associations between multiple predictors of interest (patient sociodemographic factors, prior ED utilization, and residential mobility; and area-level characteristics) and odds of a self-harm ED visit in 2010. Patients with any self-harm in 2010 were followed up over several years to assess predictors of recurrent self-harm. <br><br>RESULTS: Self-harm patients (n = 5539) were significantly more likely than control patients (n = 16,617) to have prior histories of ED utilization, particularly for mental health problems, substance abuse, and injuries. Residential mobility also increased risk of self-harm, but racial/ethnic minority status and residence in a disadvantaged zipcode decreased risk. Five-year cumulative incidence of recurrent self-harm was 19.3%. Admission as an inpatient at index visit, Medicaid insurance, and prior ED utilization for psychiatric problems or injury all increased recurrent self-harm risk. <br><br>CONCLUSIONS: A range of patient- and area-level characteristics observable in ED settings are associated with risk for subsequent self-harm among adolescents, suggesting new targets for intervention in this clinical context.<br><br>Copyright © 2018 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0163-8343",
doi="10.1016/j.genhosppsych.2018.12.004",
url="http://dx.doi.org/10.1016/j.genhosppsych.2018.12.004"
}