@article{ref1,
title="Association between unintentional injuries and self-harm among adolescent emergency department patients",
journal="General hospital psychiatry",
year="2020",
author="Phillips, Dwena and Lidón-Moyano, Cristina and Cerdá, Magdalena and Gruenewald, Paul and Goldman-Mellor, Sidra",
volume="64",
number="",
pages="87-92",
abstract="BACKGROUND: Unintentional injury, a leading cause of morbidity among adolescents, may also be a risk factor for deliberate self-harm. To inform clinical and public health prevention efforts in adolescent populations, we examined whether distinct subtypes of unintentional injury were differentially associated with deliberate self-harm. <br><br>METHODS: Statewide, all-payer, individually linkable administrative data on adolescent patients presenting to any California emergency department (ED) in 2010 (n = 490,071) were used to investigate longitudinal associations between subtypes of unintentional injury and deliberate self-harm. Adolescents aged 10-19 years presenting with unintentional drug poisoning, other poisoning, fall, suffocation, or cutting/piercing injuries formed the exposure groups; adolescents presenting with unintentional strike injuries formed the primary referent group. Study patients were followed back in time (2006-2009) to compare the groups' odds of a prior ED visit for deliberate self-harm, as well as forwards in time (2010-2015) to compare their risks of subsequent self-harm. <br><br>RESULTS: Unintentional drug-poisoning injury was strongly associated with increased likelihood of ED visits for deliberate self-harm, assessed both retrospectively (adjusted OR = 4.52; 95% confidence interval [CI] = 3.08, 6.64) and prospectively (adjusted RR = 3.74; 95% CI = 3.03, 4.60). Positive associations with odds of prior self-harm and/or risk of subsequent self-harm were also observed for patients with unintentional non-drug poisoning, suffocation, and cutting/piercing injuries. <br><br>CONCLUSIONS: Certain subtypes of unintentional injury, particularly drug poisoning, are strongly associated with risk for deliberate self-harm among adolescents, a finding with implications for targeting clinical assessment and intervention in emergency department settings. More research is needed to understand the mechanisms underlying these associations.<br><br>Copyright © 2020 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0163-8343",
doi="10.1016/j.genhosppsych.2020.03.008",
url="http://dx.doi.org/10.1016/j.genhosppsych.2020.03.008"
}