title: Young people's risk of suicide attempts after contact with a psychiatric department - a nested case-control design using Danish register data.
abstract: BACKGROUND
  There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk.
  
  
  METHODS
  A complete extraction of Danish register data for every individual born in the period 1983-1989 was made. Of these 403,431 individuals, 3,465 had attempted suicide. In order to control for confounder effects from gender, age and calendar-time, a nested case-control study was designed. A total population of 72,765 individuals was used to analyze the risk of suicide attempts after contact with a psychiatric department. The case-control data were analyzed using conditional logistic regression.
  
  
  RESULTS
  This study shows that a child/adolescent's risk of suicide attempt peaks immediately after discharge from last contact with a psychiatric department. The risk of suicide attempt is highest for children and adolescents suffering from personality disorders, depression and substance use disorders. Children and adolescents with previous contact with a psychiatric department and parental income in the lowest third have a significantly higher risk of suicide attempt. Suicide attempters were more likely to have been given several different diagnoses and several different psychopharmacological drugs prior to their attempted suicide.
  
  
  CONCLUSIONS
  The findings in this study highlight the need for psychopathology assessment in every case of attempted suicide. This study also shows that well-known risk factors such as contact with a psychiatric department do not affect all individuals in the same way. Individuals from families with low SES had the highest risk. This suggests that the presence of factors influencing both vulnerability and resiliency, e.g., family level of SES, needs to be included in the assessment.
authors.affiliation: Clinic of Suicide Prevention and Treatment for Children and Adolescents, Department of Child and Adolescent Psychiatry, Odense University Hospital, Denmark. erik.christiansen@ouh.fyns-amt.dk
authors.forename: Erik
authors.initials: E
authors.lastname: Christiansen
authors.forename: Kim Juul
authors.initials: KJ
authors.lastname: Larsen
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003718:Denmark / Q000453:epidemiology; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D010351:Patient Discharge; D010554:Personality Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012042:Registries; D055500:Resilience, Psychological; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*