Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register / Johan BJUREBERG in Journal of Child Psychology and Psychiatry, 60-3 (March 2019)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 60-3 (March 2019) . - p.295-304 Titre : Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register Type de document : texte imprimé Auteurs : Johan BJUREBERG, Auteur ; Anna OHLIS, Auteur ; B. LJOTSSON, Auteur ; Brian M. D'ONOFRIO, Auteur ; E. HEDMAN-LAGERLOF, Auteur ; Jussi JOKINEN, Auteur ; Hanna SAHLIN, Auteur ; Paul LICHTENSTEIN, Auteur ; M. CEDERLOF, Auteur ; Clara HELLNER, Auteur Article en page(s) : p.295-304 Langues : Anglais (eng) Mots-clés : Self-harm  cohort study  epidemiology  self-injurious behavior  suicidal ideation Index. décimale : PER Périodiques Résumé : BACKGROUND: Self-harm is common and there is a need for studies that investigate the relevance of this behavior in clinical samples to inform risk assessment and treatment. The objectives in the current studies were to compare clinical and psychosocial correlates and subsequent adverse outcomes in youth who present to child and adolescent mental health services (CAMHS) with self-harm only (SH), self-harm with suicidality (SH+SU), with those without any indication of SH or SH+SU. METHODS: We conducted a case-control study and a longitudinal cohort study using data from a regional clinical care register, and Swedish national registers. The case-control study included all patients (5-17 years) between 2011 and 2015 (N = 25,161). SH and SH+SU cases were compared with controls (patients without SH) regarding a range of correlates. The longitudinal study included former CAMHS patients (N = 6,120) who were followed for a median time of 2.8 years after termination of CAMHS contact regarding outcomes such as clinical care consumption, social welfare recipiency, and crime conviction. RESULTS: In the case-control study, both the SH and SH+SU groups received more clinical care, had lower global functioning, and higher odds of having mental disorders compared to controls. In most comparisons, the SH+SU group had more problems than the SH group. In the longitudinal study, the same pattern emerged for most outcomes; for example, the adjusted hazard ratio for recurrent care due to self-harm was 23.1 (95% confidence interval [CI], 17.0-31.4) in the SH+SU group compared to 3.9 (95% CI, 2.3-6.7) in the SH group. CONCLUSIONS: Adolescent patients presenting with self-harm have higher risks for adverse outcomes than patients without self-harm. Suicidality in addition to self-harm is associated with more severe outcomes, importantly recurrent episodes of care for self-harm. En ligne : https://dx.doi.org/10.1111/jcpp.12967 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=385 [article] Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register [texte imprimé] / Johan BJUREBERG, Auteur ; Anna OHLIS, Auteur ; B. LJOTSSON, Auteur ; Brian M. D'ONOFRIO, Auteur ; E. HEDMAN-LAGERLOF, Auteur ; Jussi JOKINEN, Auteur ; Hanna SAHLIN, Auteur ; Paul LICHTENSTEIN, Auteur ; M. CEDERLOF, Auteur ; Clara HELLNER, Auteur . - p.295-304. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 60-3 (March 2019) . - p.295-304 Mots-clés : Self-harm  cohort study  epidemiology  self-injurious behavior  suicidal ideation Index. décimale : PER Périodiques Résumé : BACKGROUND: Self-harm is common and there is a need for studies that investigate the relevance of this behavior in clinical samples to inform risk assessment and treatment. The objectives in the current studies were to compare clinical and psychosocial correlates and subsequent adverse outcomes in youth who present to child and adolescent mental health services (CAMHS) with self-harm only (SH), self-harm with suicidality (SH+SU), with those without any indication of SH or SH+SU. METHODS: We conducted a case-control study and a longitudinal cohort study using data from a regional clinical care register, and Swedish national registers. The case-control study included all patients (5-17 years) between 2011 and 2015 (N = 25,161). SH and SH+SU cases were compared with controls (patients without SH) regarding a range of correlates. The longitudinal study included former CAMHS patients (N = 6,120) who were followed for a median time of 2.8 years after termination of CAMHS contact regarding outcomes such as clinical care consumption, social welfare recipiency, and crime conviction. RESULTS: In the case-control study, both the SH and SH+SU groups received more clinical care, had lower global functioning, and higher odds of having mental disorders compared to controls. In most comparisons, the SH+SU group had more problems than the SH group. In the longitudinal study, the same pattern emerged for most outcomes; for example, the adjusted hazard ratio for recurrent care due to self-harm was 23.1 (95% confidence interval [CI], 17.0-31.4) in the SH+SU group compared to 3.9 (95% CI, 2.3-6.7) in the SH group. CONCLUSIONS: Adolescent patients presenting with self-harm have higher risks for adverse outcomes than patients without self-harm. Suicidality in addition to self-harm is associated with more severe outcomes, importantly recurrent episodes of care for self-harm. En ligne : https://dx.doi.org/10.1111/jcpp.12967 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=385

Adverse clinical outcomes among youths with nonsuicidal self-injury and suicide attempts: a longitudinal cohort study / Johan BJUREBERG in Journal of Child Psychology and Psychiatry, 63-8 (August 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-8 (August 2022) . - p.921-928 Titre : Adverse clinical outcomes among youths with nonsuicidal self-injury and suicide attempts: a longitudinal cohort study Type de document : texte imprimé Auteurs : Johan BJUREBERG, Auteur ; Ralf KUJA-HALKOLA, Auteur ; Anna OHLIS, Auteur ; Paul LICHTENSTEIN, Auteur ; Brian M. D'ONOFRIO, Auteur ; Clara HELLNER, Auteur ; Martin CEDERLOF, Auteur Article en page(s) : p.921-928 Langues : Anglais (eng) Mots-clés : Adolescent  Cohort Studies  Humans  Longitudinal Studies  Risk Factors  Self-Injurious Behavior/epidemiology/psychology/therapy  Substance-Related Disorders/epidemiology/therapy  Suicidal Ideation  Suicide, Attempted/psychology  Self-injury  self-harm  suicidal behaviour Index. décimale : PER Périodiques Résumé : BACKGROUND: More knowledge about risks of clinical outcomes associated with nonsuicidal self-injury (NSSI) and suicide attempts (SAs) is needed to inform risk assessment and intervention. METHODS: Longitudinal cohort study based on 1,855 youths was clinically assessed for NSSI and SA, and followed up (from December, 2011 to December 2013) for the outcomes; diagnosed self-injury, alcohol/substance use disorder, and psychiatric inpatient care data derived from Swedish registers. Hazard ratios (HRs) and 95% confidence intervals (CIs) of the outcomes were estimated with Cox regressions, and additionally adjusted for the potential effect of sex and the number of clinical assessments. NSSI and SA were treated as time-varying covariates. RESULTS: Youths with NSSI had elevated risks of all outcomes, compared with youths without NSSI or SA; the HR was 2.3, 95% confidence interval [1.6, 3.4] for self-injury, 1.4 [0.9, 2.1] for alcohol/substance use disorder, and 1.3 [1.0, 1.7] for psychiatric inpatient care. Youths with SA displayed higher risks for the outcomes than the NSSI group; the HR was 5.5 [2.4, 12.6] for self-injury, 2.0 [0.9, 4.4] for alcohol/substance use disorder, and 2.6 [1.5, 4.5] for psychiatric inpatient care. Youths with both NSSI and SA showed similar risks as youths with SA; HR 4.1 [2.0, 8.3] for self-injury, 2.0 [1.1, 4.1] for alcohol/substance use disorder, but a higher risk of psychiatric inpatient care; HR 5.0 [3.1, 7.9]. All results remained virtually unchanged in the adjusted analyses. CONCLUSIONS: Youths with NSSI and/or SA had higher risks for subsequent adverse clinical outcomes. These excess risks were more pronounced among youths with SA and youths with both NSSI and SA, and the risk for psychiatric inpatient care was particularly high in youths with both NSSI and SA. Our findings suggest that early interventions for youths with NSSI or SA should not exclusively focus on suicide prevention, but also consider the risk of subsequent alcohol/substance use disorder. En ligne : http://dx.doi.org/10.1111/jcpp.13544 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=486 [article] Adverse clinical outcomes among youths with nonsuicidal self-injury and suicide attempts: a longitudinal cohort study [texte imprimé] / Johan BJUREBERG, Auteur ; Ralf KUJA-HALKOLA, Auteur ; Anna OHLIS, Auteur ; Paul LICHTENSTEIN, Auteur ; Brian M. D'ONOFRIO, Auteur ; Clara HELLNER, Auteur ; Martin CEDERLOF, Auteur . - p.921-928. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-8 (August 2022) . - p.921-928 Mots-clés : Adolescent  Cohort Studies  Humans  Longitudinal Studies  Risk Factors  Self-Injurious Behavior/epidemiology/psychology/therapy  Substance-Related Disorders/epidemiology/therapy  Suicidal Ideation  Suicide, Attempted/psychology  Self-injury  self-harm  suicidal behaviour Index. décimale : PER Périodiques Résumé : BACKGROUND: More knowledge about risks of clinical outcomes associated with nonsuicidal self-injury (NSSI) and suicide attempts (SAs) is needed to inform risk assessment and intervention. METHODS: Longitudinal cohort study based on 1,855 youths was clinically assessed for NSSI and SA, and followed up (from December, 2011 to December 2013) for the outcomes; diagnosed self-injury, alcohol/substance use disorder, and psychiatric inpatient care data derived from Swedish registers. Hazard ratios (HRs) and 95% confidence intervals (CIs) of the outcomes were estimated with Cox regressions, and additionally adjusted for the potential effect of sex and the number of clinical assessments. NSSI and SA were treated as time-varying covariates. RESULTS: Youths with NSSI had elevated risks of all outcomes, compared with youths without NSSI or SA; the HR was 2.3, 95% confidence interval [1.6, 3.4] for self-injury, 1.4 [0.9, 2.1] for alcohol/substance use disorder, and 1.3 [1.0, 1.7] for psychiatric inpatient care. Youths with SA displayed higher risks for the outcomes than the NSSI group; the HR was 5.5 [2.4, 12.6] for self-injury, 2.0 [0.9, 4.4] for alcohol/substance use disorder, and 2.6 [1.5, 4.5] for psychiatric inpatient care. Youths with both NSSI and SA showed similar risks as youths with SA; HR 4.1 [2.0, 8.3] for self-injury, 2.0 [1.1, 4.1] for alcohol/substance use disorder, but a higher risk of psychiatric inpatient care; HR 5.0 [3.1, 7.9]. All results remained virtually unchanged in the adjusted analyses. CONCLUSIONS: Youths with NSSI and/or SA had higher risks for subsequent adverse clinical outcomes. These excess risks were more pronounced among youths with SA and youths with both NSSI and SA, and the risk for psychiatric inpatient care was particularly high in youths with both NSSI and SA. Our findings suggest that early interventions for youths with NSSI or SA should not exclusively focus on suicide prevention, but also consider the risk of subsequent alcohol/substance use disorder. En ligne : http://dx.doi.org/10.1111/jcpp.13544 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=486

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