@article{ref1,
title="Characteristics associated with serious self-harm events in children and adolescents",
journal="Pediatrics",
year="2023",
author="Sekmen, Mert and Grijalva, Carlos G. and Zhu, Yuwei and Williams, Derek J. and Feinstein, James A. and Stassun, Justine C. and Johnson, Jakobi A. and Tanguturi, Yasas C. and Gay, James C. and Antoon, James W.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: To identify patterns of psychiatric comorbidity among children and adolescents with a serious self-harm event. <br><br>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. <br><br>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). <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2022-059817",
url="http://dx.doi.org/10.1542/peds.2022-059817"
}