Risk for attempted suicide in children and youths after contact with somatic hospitals: a Danish register based nested case-control study.
BACKGROUND
A range of studies have found an association between some somatic diseases and increased risk of suicide and attempted suicide. These studies are mostly analyses of adult populations and illnesses related to adulthood.


OBJECTIVE
To study the risk of attempted suicide in children and youths with a somatic diagnosis, and to assess a possible association from a somatic perspective.


METHODS
From a cohort of 403 431 individuals (born 1983-89), 3465 children and youths who had attempted suicide were identified. Each case was matched with 20 population controls. 72 765 children and youths constituted the case-control population. All data were obtained from national population registers and analysed in a nested case-control design.


RESULTS
Contact of children and youths with a somatic hospital is correlated with increased risk of attempted suicide; the risk peaks in the time immediately after contact. Risk factors were treatment for injury caused by violence, epilepsy, asthma and malformation for males; and spontaneous and medical abortions, treatment for injury caused by violence, epilepsy, asthma, insulin dependent diabetes mellitus and malformation for females. Not all the mentioned diagnoses were significant in the adjusted model.


CONCLUSIONS
Based on the results of the study a strategy to minimise the risk of attempted suicide among children and youths must be implemented. The strategy should mainly focus on children at high risk-that is, children from families with low socioeconomic status, and children with a psychiatric history, a history of previous suicide attempts and with an unstable somatic disease subsequently causing many admissions.
Clinic of Suicide Prevention and Treatment for Children and Adolescents, Department of Child and Adolescent Psychiatry, Odense University Hospital, Bjergegade 15, 1st floor, DK-5000 Odense C, Denmark. erik.christiansen@ouh.fyns-amt.dk
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Christiansen
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Stenager
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D035061:Control Groups; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D012042:Registries; D012308:Risk Management; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000628:therapy