Nadine Dougall, Jan Savinc, Margaret Maxwell, Thanos Karatzias, Rory C O'Connor, Brian Williams, Ann John, Helen Cheyne, Claire Fyvie, Jonathan I Bisson, Carina Hibberd, Susan Abbott-Smith, Liz Nolan, Jennifer Murray
{"title":"1981-2017年英国苏格兰青少年自杀前的童年逆境和心理健康入院模式（CHASE）：一项为期36年的病例对照关联医院数据研究。","authors":"Nadine Dougall, Jan Savinc, Margaret Maxwell, Thanos Karatzias, Rory C O'Connor, Brian Williams, Ann John, Helen Cheyne, Claire Fyvie, Jonathan I Bisson, Carina Hibberd, Susan Abbott-Smith, Liz Nolan, Jennifer Murray","doi":"10.1192/bjo.2024.69","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Childhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.</p><p><strong>Aim: </strong>To determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.</p><p><strong>Method: </strong>Population-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).</p><p><strong>Results: </strong>Records were extracted for 2477 'cases' and 24 777 'controls'; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10-17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4-3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7-7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aOR<sub>male</sub> = 8.17 (95% CI, 5.02-13.29), aOR<sub>female</sub> = 15.08 (95% CI, 8.07-28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aOR<sub>male</sub> = 1.90 (95% CI, 1.64-2.21), aOR<sub>female</sub> = 2.65 (95% CI, 1.94-3.62), and each mental health admission by aOR<sub>male</sub> = 2.06 (95% CI, 1.81-2.34), aOR<sub>female</sub> = 1.78 (95% CI, 1.50-2.10).</p><p><strong>Conclusions: </strong>Our lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential 'at-risk' adolescents to prevent future suicidal acts, especially those in general hospitals.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"10 4","pages":"e124"},"PeriodicalIF":3.9000,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363076/pdf/","citationCount":"0","resultStr":"{\"title\":\"Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981-2017.\",\"authors\":\"Nadine Dougall, Jan Savinc, Margaret Maxwell, Thanos Karatzias, Rory C O'Connor, Brian Williams, Ann John, Helen Cheyne, Claire Fyvie, Jonathan I Bisson, Carina Hibberd, Susan Abbott-Smith, Liz Nolan, Jennifer Murray\",\"doi\":\"10.1192/bjo.2024.69\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Childhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.</p><p><strong>Aim: </strong>To determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.</p><p><strong>Method: </strong>Population-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).</p><p><strong>Results: </strong>Records were extracted for 2477 'cases' and 24 777 'controls'; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10-17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4-3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7-7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aOR<sub>male</sub> = 8.17 (95% CI, 5.02-13.29), aOR<sub>female</sub> = 15.08 (95% CI, 8.07-28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aOR<sub>male</sub> = 1.90 (95% CI, 1.64-2.21), aOR<sub>female</sub> = 2.65 (95% CI, 1.94-3.62), and each mental health admission by aOR<sub>male</sub> = 2.06 (95% CI, 1.81-2.34), aOR<sub>female</sub> = 1.78 (95% CI, 1.50-2.10).</p><p><strong>Conclusions: </strong>Our lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential 'at-risk' adolescents to prevent future suicidal acts, especially those in general hospitals.</p>\",\"PeriodicalId\":9038,\"journal\":{\"name\":\"BJPsych Open\",\"volume\":\"10 4\",\"pages\":\"e124\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363076/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJPsych Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1192/bjo.2024.69\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJPsych Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1192/bjo.2024.69","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981-2017.
Background: Childhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.
Aim: To determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.
Method: Population-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).
Results: Records were extracted for 2477 'cases' and 24 777 'controls'; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10-17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4-3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7-7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aORmale = 8.17 (95% CI, 5.02-13.29), aORfemale = 15.08 (95% CI, 8.07-28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aORmale = 1.90 (95% CI, 1.64-2.21), aORfemale = 2.65 (95% CI, 1.94-3.62), and each mental health admission by aORmale = 2.06 (95% CI, 1.81-2.34), aORfemale = 1.78 (95% CI, 1.50-2.10).
Conclusions: Our lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential 'at-risk' adolescents to prevent future suicidal acts, especially those in general hospitals.
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Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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