Child and Adolescent Suicidal Ideation and Suicide Attempts: Evidence from the Healthcare Cost and Utilization Project

• Published in: The Journal of pediatrics 2019-03, Vol.206, p.225-231
• Main Authors: Carbone, Jason T., Holzer, Katherine J., Vaughn, Michael G.
• Format: Article
• Language: English
• Subjects: hospital emergency department; nationally-representative data; suicidal ideation; suicide attempt
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2018.10.017

To examine the trends associated with child and adolescent suicidal ideation and suicide attempts and to compare these trends to those among the adult population. A nationally representative sample of administrative billing data was used for the analysis, which included descriptive statistics, trend data, and logistic regression. There were 874 872 (95% CI, 810 574-939 169) children and adolescents and 5 561 197 (95% CI, 5 271 426-5 850 968) adults admitted to an emergency department who experienced suicidal ideation or suicide attempts between 2010 and 2014, representing 1.20% of admissions for children (95% CI, 1.13-1.37) and adolescents and 1.09% of admissions for adults (95% CI, 1.05-1.13). Children and adolescents were more likely to be female (aOR, 1.74; 95% CI, 1.71-1.78) and to have private insurance (aOR, 1.75; 95% CI, 1.68-1.83) as compared with adults. Although the percentage of admissions increased for adults 25 and older (18.95%) the greatest increases were found among children and adolescents (5-11 years of age, 37.87%; 12-14 years of age, 82.03%; 15-17 years of age, 51.59%; and 18-24 years of age, 26.77%). There is a seasonal trend for children and adolescents such that higher rates are associated with the school year, which is not present for adults. Practitioners should be cognizant of the fact that suicidal ideation and suicide attempts for youth present differently than they do for the greater population and they should be vigilant in identifying risk factors, especially during seasons where risk of self-harm increases.