Injury risk in young psychiatric outpatients: An 11-year follow-up of 302 adolescents

• Published in: Social Psychiatry and Psychiatric Epidemiology 2008-08, Vol.43 (8), p.627-634
• Main Authors: Mattila, Ville M., Pelkonen, Mirjami, Henriksson, Markus, Marttunen, Mauri
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior - psychology; Adult and adolescent clinical studies; Biological and medical sciences; Child; Child & adolescent psychiatry; Cohort analysis; Data collection; Drug use; Epidemiology; Female; Finland - epidemiology; Follow-Up Studies; Hospitalization; Humans; Incidence; Injuries; Male; Medical sciences; Medicine; Medicine & Public Health; Mental disorders; Mental Disorders - complications; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental health; Outpatients - statistics & numerical data; Poisoning; Poisoning - epidemiology; Poisoning - psychology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotropic drugs; Risk factors; Self destructive behavior; Suicidal behavior; Suicide; Suicides & suicide attempts; Teenagers; Wounds and Injuries - epidemiology; Wounds and Injuries - psychology; Young Adult; Young adults
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-008-0343-z

Background Studies investigating the association between injuries and mental health have mainly focused on mental health sequelae of injuries. The aim of this prospective cohort study was to assess the incidence and risk factors of physical injury hospitalisation and poisoning hospitalisation among adolescent psychiatric outpatients. Subjects and methods Data on 302 consecutively referred Finnish psychiatric outpatients aged 12–22 years (mean 16) were collected at treatment entry. The end-point of the average 11-year follow-up was death or end of follow-up on 31 December 2005. The main outcome variables were physical injury hospitalisation and poisoning hospitalisation. Results Altogether 111 physical injury hospitalisations occurred in 65 (22% of all) persons during follow-up, incidence being 27.9 (95% CI: 22.7–33.1) per 1,000 person-years. Poisoning hospitalisation occurred in 22 (7.3%) persons, altogether 50 times, incidence being 12.6 (95% CI: 9.1–16.0). Seven injury-related deaths occurred, incidence being 1.8 (95% CI: 0.5–3.1) per 1,000 person-years. The most common physical injury types were fractures (40%), followed by distortions (10%) and wounds (10%), while poisoning for drugs accounted for 72% of the poisonings. Previous inpatient care, psychotropic medication, suicidality, and major depression were associated with poisoning hospitalisation during the follow-up while only gender was associated with physical injury hospitalisation. Conclusion Injuries cause significant morbidity among psychiatric outpatients, but only poisonings seem to be related with suicidality in Finnish adolescent psychiatric outpatients. The high frequency of injuries seems to justify clinicians’ attention to these aspects when assessing the need for care among young people.