Correlates of deliberate self-harm among youth with bipolar disorder.
Correlates of deliberate self-harm among youth with bipolar disorder.
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DOI：
10.1016/j.jad.2022.01.085
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发表时间：
2022-04-01
影响因子：
6.6
通讯作者：
Fontanella CA
中科院分区：
文献类型：
--
作者：
Llamocca EN;Fristad MA;Bridge JA;Brock G;Steelesmith DL;Axelson DA;Fontanella CA
青少年双相情感障碍（BD）是在故意自我伤害（DSH）和自杀的高风险。然而，关于BD青少年中与DSH（一个关键的自杀风险因素）相关的因素的研究有限。因此，在以人群为基础的BD青年样本中，我们调查了人口统计学、临床和服务利用因素与DSH发病率之间的相关性，并将自杀、意外伤害和全因死亡率与普通人群进行了比较。我们使用俄亥俄州医疗补助索赔和死亡证明数据，分析了2010年至2017年期间新发BD的5至19岁青年（n = 25，244）的回顾性队列。考克斯比例风险模型研究了不同因素与DSH之间的关联。使用标准化死亡率比将死亡率与一般人群进行比较。在随访期间，1，517名（6.0%）青少年至少发生了一次DSH事件。年龄较大、女性、共病精神/医疗状况、既往DSH/自杀想法和既往急诊室心理保健与DSH风险增加相关。既往DSH与新BD发作后3个月内DSH风险增加最密切相关。非西班牙裔黑人（与非西班牙裔白色人相比）和既往精神病住院治疗与DSH风险降低相关。新BD发作后3个月DSH风险最高。BD青年患者的自杀、意外伤害和全因死亡率升高。可能不会推广到其他州或非医疗补助人群;索赔数据无法区分自杀意图的自我伤害早期干预后，一个新的BD事件，特别是在高风险群体，是关键，以防止DSH。
Youth with bipolar disorder (BD) are at high risk for deliberate self-harm (DSH) and suicide. However, research regarding factors associated with DSH, a key suicide risk factor, among youth with BD is limited. In a population-based sample of youth with BD, we therefore investigated associations between demographic, clinical, and service utilization factors and DSH incidence and compared suicide, unintentional injury, and all-cause mortality to the general population. We analyzed a retrospective cohort of youth aged 5 to 19 years with a new BD episode between 2010 and 2017 (n = 25,244) using Ohio Medicaid claims and death certificate data. Cox proportional hazards models examined associations between different factors and DSH. Mortality rates were compared to the general population using standardized mortality ratios. During follow-up, 1,517 (6.0%) youth had at least one DSH event. Older index age, female sex, comorbid psychiatric/medical conditions, prior DSH/suicidal ideation, and prior ER mental healthcare were associated with increased DSH risk. Prior DSH was most strongly associated with increased DSH risk for 3 months after a new BD episode. Being non-Hispanic Black (vs. White, non-Hispanic) and prior psychiatric hospitalization were associated with decreased DSH hazard. DSH risk was highest for 3 months after a new BD episode. Suicide, unintentional injury, and all-cause mortality rates were elevated in youth with BD. May not generalize to other states or non-Medicaid populations; claims data cannot distinguish suicidal intent of self-harm Early intervention following a new BD episode, particularly among high-risk groups, is key to prevent DSH.
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DOI：
10.1016/j.chc.2008.11.005
发表时间：
2009-04
影响因子：
2.4
作者：
Goldstein TR
通讯作者：
Goldstein TR
影响因子：
2.4
作者：
Feudtner C;Feinstein JA;Zhong W;Hall M;Dai D
通讯作者：
Dai D
DOI：
10.1007/s00406-002-0357-6
发表时间：
2002-08-01
影响因子：
4.7
作者：
Angst, J;Sellaro, R;Merikangas, KR
通讯作者：
Merikangas, KR
DOI：
10.1097/00004583-199305000-00006
发表时间：
1993-05-01
影响因子：
13.3
作者：
BRENT, DA;PERPER, JA;BAUGHER, M
通讯作者：
BAUGHER, M
DOI：
10.1080/23794925.2021.1888664
发表时间：
2021
期刊：
Evidence-based practice in child and adolescent mental health
影响因子：
--
作者：
通讯作者：
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