Self-harm among adolescents is growing, according to a study published in the July issue of Pediatrics, the journal of the American Academy of Pediatrics.
Researchers gathered information using the National Trauma Data Bank, looking at patients ages 10 to 18 from 2009 to 2012. They examined 286,678 adolescent trauma patients, 3,664 of whom sustained a self-inflicted injury. The goal was to examine trends in SII mechanisms and identify factors associated with increased risk.
Results showed ED visits for SII increased from 1.1% in 2009 to 1.6% in 2012. Self-inflicted firearm visits decreased from 27.3% in 2009 to 21.9% in 2012. The most common mechanism in males was firearm (34.4%) and in females, cut/pierce at 48%.
The study showed that only 4.9% of adolescents with an SII were diagnosed with a mental disorder. About half (47.2%) had depressive disorders. Cutting or piercing was the most common mechanism of injuries followed by firearm. Poisoning was the least common.
Females are more likely to visit the ED for SII injuries compared with males. Males have been shown to have a greater risk of dying from injuries likely because their method is more lethal, such as firearms, according to the study.
The odds of SII were higher for females, older adolescents, adolescents with comorbid conditions and Asian adolescents, and lower in African-American adolescents.
Adolescent suicide risk high
Adolescents with an SII had higher odds of death than those with other injuries. “Adolescent suicide is a major public health problem and one of the leading causes of death in this age group,” researchers wrote in the study. “Self-harm behavior is rare under the age of 12 but increases rapidly through adolescence, especially among females.”
There is a high risk for subsequent successful suicide attempts among adolescents who self-harm, therefore, the National Strategy for Suicide Prevention in the U.S. identifies them as a high-risk group, researchers wrote.
Researchers noted in their study that other data on self-harm showed the average number of ED visits for attempted suicide and SII more than doubled between 1993 and 2008. Visits were most common among adolescents ages 15 to 19, they wrote. Mortality rates increased by 15% from 2000 to 2009, and suicide has surpassed motor vehicle traffic crashes as the leading cause of injury mortality in the U.S.
Researchers concluded ED providers have a unique opportunity to intervene with SII patients during a high-risk period.
“Our findings provide potential targets for SII prevention efforts specific to the ED setting or for the general population,” the authors wrote. “Specific subgroups of adolescents who may benefit from increased prevention efforts include those with public or no insurance and those with one or more comorbid conditions.”
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