title: Violence, self-harm and drug or alcohol misuse in adolescents admitted to hospitals in England for injury: a retrospective cohort study.
abstract: OBJECTIVE
  Of adolescents in the general population in England, we aimed to determine (1) the proportion that has an emergency admission to hospital for injury related to adversity (violence, self-harm or drug or alcohol misuse) and (2) the risk of recurrent emergency admissions for injury in adolescents admitted with adversity-related injury compared with those admitted with accident-related injury only.
  
  
  METHODS
  We used longitudinally linked administrative hospital data (Hospital Episode Statistics) to identify participants aged 10-19 years with emergency admissions for injury (including day cases lasting more than 4 h) in England in 1998-2011. We used the Office for National Statistics mid-year estimates for population denominators.
  
  
  RESULTS
  Approximately 4.3% (n=141 248) of adolescents in the general population (n=3 254 046) had one or more emergency admissions for adversity-related injury (girls 4.6%, boys 4.1%), accounting for 50% of all emergency admissions for injury in girls and 29.1% in boys. Admissions for self-harm or drug or alcohol misuse commonly occurred in the same girls and boys. Recurrent emergency admissions for injury were more common in adolescents with adversity-related injury (girls 17.3%, boys 16.5%) than in those with accident-related injury only (girls 4.7%, boys 7.4%), particularly for adolescents with adversity-related injury related to multiple types of adversity (girls 21.1%, boys 24.2%).
  
  
  CONCLUSIONS
  Hospital-based interventions should be developed to reduce the risk of future injury in adolescents admitted for adversity-related injury.
authors: Population, Policy & Practice Programme, University College London Institute of Child Health, London, UK.
authors: Annie
authors: A
authors: Herbert
authors: Population, Policy & Practice Programme, University College London Institute of Child Health, London, UK.
authors: Ruth
authors: R
authors: Gilbert
authors: Population, Policy & Practice Programme, University College London Institute of Child Health, London, UK.
authors: Arturo
authors: A
authors: González-Izquierdo
authors: Population, Policy & Practice Programme, University College London Institute of Child Health, London, UK.
authors: Leah
authors: L
authors: Li
mesh_terms: D000059:Accidents; D000293:Adolescent; D002648:Child; D004636:Emergency Service, Hospital; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D008297:Male; D010343:Patient Admission; D015995:Prevalence; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications; D014754:Violence; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*
keywords: MENTAL HEALTH