Injuries in children and adolescents with psychiatric disorders

Agnafors, Sara; Torgerson, Jarl; Rusner, Marie; Kjellström, Anna

doi:10.1186/s12889-020-09283-3

Cited by 11 publications

(25 citation statements)

References 44 publications

(60 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of 36 results were retrieved from the 31 studies. 9 , 16 , 17 , 18 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 Twenty-nine of the 36 results showed a significant association between ASD and self-harm, 9 , 18 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 60 , 61 , 63 , 64 , 66 , 67 , 68 , 69 , 70 , 71 , 72 and people with ASD were at similarly increased risk of both self-injurious behavior and suicidality. Included studies were published from 1999 to 2021.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 31 studies, 6 (19%) recruited participants in a clinical setting 9 , 53 , 59 , 65 , 71 , 72 and 25 (81%) recruited participants in a nonclinical setting 16 , 17 , 18 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 54 , 55 , 56 , 57 , 58 , 60 , 61 , 62 , 63 , 64 , 66 , 67 , 68 , 69 , 70 (eFigure 1 in the Supplement ). Most studies (n = 22 [71%]) used the general population without ASD as the control group.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies (n = 22 [71%]) used the general population without ASD as the control group. 9 , 16 , 17 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 56 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 66 , 68 , 72 Nine studies (29%) used individuals with neurodevelopmental or neuropsychiatric conditions or special education eligibility without ASD as control participants. 18 , 54 , 55 , 57 , 63 , 67 , 69 , 70 , 71 Fifteen studies (48%) investigated self-injurious behavior without suicidality, 9 , 18 , 46 , 47 , 50 , 54 , 55 , 56 , 57 , 62 , 63 , 65 , 67 , 69 , 70 14 studies (45%) investigated suicidality (ie, suicidal ideation, suicide attempt, or suicide), 16 , 17 , 49 , 51 , 52 , 53 , 58 , 59 , 60 , ...…”

Section: Resultsmentioning

confidence: 99%

“…In pooled data, people with ASD had 2.26-times higher odds of self-harm than those without ASD (pooled OR, 3.26; 95% CI, 2.74-3.89; I 2 = 92.56%). Seventeen studies 9 , 18 , 46 , 47 , 48 , 50 , 54 , 55 , 56 , 57 , 62 , 63 , 65 , 67 , 69 , 70 , 72 assessed the association between ASD and self-injurious behavior and reported ORs that ranged from 1.21 to 18.76. Sixteen studies 16 , 17 , 48 , 49 , 51 , 52 , 53 , 58 , 59 , 60 , 61 , 64 , 66 , 68 , 71 , 72 assessed the association between ASD and suicidality and reported ORs that ranged from 0.86 to 11.10.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Risk of Self-harm in Children and Adults With Autism Spectrum Disorder

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Multiple studies have reported that people with autism spectrum disorder (ASD) are at a higher risk for self-injurious behavior and suicide. However, the magnitude of this association varies between studies. OBJECTIVE To appraise the available epidemiologic studies on the risk of self-injurious behavior and suicidality among children and adults with ASD.DATA SOURCES PubMed, Embase, CINAHL, PsycINFO, and Web of Science were systematically searched for epidemiologic studies on the association between ASD and self-injurious behavior and suicidality. Databases were searched from year of inception to April through June 2020. No language, age, or date restrictions were applied.STUDY SELECTION This systematic review and meta-analysis included studies with an observational design and compared self-injurious behavior (defined as nonaccidental behavior resulting in self-inflicted physical injury but without intent of suicide or sexual arousal) and/or suicidality (defined as suicidal ideation, suicide attempt, or suicide) in children (aged <20 years) or adults (aged Ն20 years) with ASD. DATA EXTRACTION AND SYNTHESISInformation on study design, study population, ASD and selfharm definitions, and outcomes were extracted by independent investigators. Study quality was assessed using the Newcastle-Ottawa Scale. Overall summary odds ratios (ORs) and 95% CIs were estimated using DerSimonian-Laird random-effects models. MAIN OUTCOMES AND MEASURESThe ORs for the associations of ASD with self-injurious behavior and suicidality were calculated. Analyses were stratified by study setting and age groups as planned a priori. RESULTSThe search identified 31 eligible studies, which were of moderate to high quality. Of these studies, 16 (52%) were conducted in children, 13 (42%) in adults, and 2 (6%) in both children and adults. Seventeen studies assessed the association between ASD and self-injurious behavior and reported ORs that ranged from 1.21 to 18.76, resulting in a pooled OR of 3.18 (95% CI, 2.45-4.12).Sixteen studies assessed the association between ASD and suicidality and reported ORs that ranged from 0.86 to 11.10, resulting in a pooled OR of 3.32 (95% CI, 2.60-4.24). In stratified analyses, results were consistent between clinical and nonclinical settings and between children and adults. CONCLUSIONS AND RELEVANCEThis study found that ASD was associated with a substantial increase in odds of self-injurious behavior and suicidality in children and adults. Further research is (continued) Key Points Question What excess risk of self-harm, including self-injurious behaviors and suicidality, is associated with autism spectrum disorder (ASD)? Findings This systematic review and meta-analysis of 31 studies found that the pooled odds of self-harm in people with ASD was more than 3 times the odds in people without ASD. The excess odds of self-harm were found in both children and adults (although a slightly higher risk was identified in adults) across geographic regions and regardless of study designs, methods, and settings. Mea...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Risk of Self-harm in Children and Adults With Autism Spectrum Disorder

et al. 2021

View full text Add to dashboard Cite

show abstract

“…There are no national reference data on traumatic events in children, but a recent study of a large population-based cohort of Swedish children and adolescents demonstrated a general pattern of increased risk for concurrent injuries with most psychiatric diagnoses. 23 Early identification of physical child abuse by healthcare professionals is essential to prevent further maltreatment and in the worstcase scenario, death. According to King et.…”

Section: Discussionmentioning

confidence: 99%

Children’s advocacy centre fails to respond to dental, mental and physical ill‐health in abused children

Göransson¹,

Ekermann²,

Dovik³

et al. 2022

Acta Paediatrica

View full text Add to dashboard Cite

In 1979, Sweden introduced an amendment in The Parental Code Act which prohibits parents from using physical punishment against a child. All Swedish professionals who have reason to suspect child abuse and neglect are legally obligated to report to child protective services (CPS). The UN Convention on the Rights of the Child (UNCRC) entered into force in Sweden in 1990 and became statutory in January 2020. Article 24 of the UNCRC states that children have the right to the best possible health, access to health care and rehabilitation. Promotion of good health is enshrined in the Swedish Health Care Act and Dental Care Act, respectively. 1,2

show abstract

Self-Harm Events and Suicide Deaths Among Autistic Individuals in Ontario, Canada

Lai

Saunders

Huang³

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceReasons for elevated suicide risks among autistic people are unclear, with insufficient population-based research on sex-specific patterns to inform tailored prevention and intervention.ObjectivesTo examine sex-stratified rates of self-harm events and suicide death among autistic individuals compared with nonautistic individuals, as well as the associated sociodemographic and clinical risk factors.Design, Setting, and ParticipantsThis population-based matched-cohort study using linked health administrative databases in Ontario, Canada included all individuals with physician-recorded autism diagnoses from April 1, 1988, to March 31, 2018, each matched on age and sex to 4 nonautistic individuals from the general population. Self-harm events resulting in emergency health care from April 1, 2005, to December 31, 2020, were examined for one cohort, and death by suicide and other causes from April 1, 1993, to December 31, 2018, were examined for another cohort. Statistical analyses were conducted between October 2021 and June 2023.ExposurePhysician-recorded autism diagnoses from 1988 to 2018 from health administrative databases.Main Outcomes and MeasuresAutistic and nonautistic individuals who were sex stratified a priori were compared using Andersen-Gill recurrent event models on self-harm events, and cause-specific competing risk models on death by suicide or other causes. Neighborhood-level income and rurality indices, and individual-level broad diagnostic categories of intellectual disabilities, mood and anxiety disorders, schizophrenia spectrum disorders, substance use disorders, and personality disorders were covariates.ResultsFor self-harm events (cohort, 379 630 individuals; median age at maximum follow-up, 20 years [IQR, 15-28 years]; median age of first autism diagnosis claim for autistic individuals, 9 years [IQR, 4-15 years]; 19 800 autistic females, 56 126 autistic males 79 200 nonautistic females, and 224 504 nonautistic males), among both sexes, autism diagnoses had independent associations with self-harm events (females: relative rate, 1.83; 95% CI, 1.61-2.08; males: relative rate, 1.47; 95% CI, 1.28-1.69) after accounting for income, rurality, intellectual disabilities, and psychiatric diagnoses. For suicide death (cohort, 334 690 individuals; median age at maximum follow-up, 19 years [IQR, 14-27 years]; median age of first autism diagnosis claim for autistic individuals, 10 years [IQR, 5-16 years]; 17 982 autistic females, 48 956 autistic males, 71 928 nonautistic females, 195 824 nonautistic males), there was a significantly higher crude hazard ratio among autistic females (1.98; 95% CI, 1.11-3.56) and a nonsignificantly higher crude hazard ratio among autistic males (1.34; 95% CI, 0.99-1.82); the increased risks were associated with psychiatric diagnoses.Conclusions and RelevanceThis cohort study suggests that autistic individuals experienced increased risks of self-harm events and suicide death. Psychiatric diagnoses were significantly associated with the increased risks among both sexes, especially for suicide death, and in partially sex-unique ways. Autism-tailored and autism-informed clinical and social support to reduce suicide risks should consider multifactorial mechanisms, with a particular focus on the prevention and timely treatment of psychiatric illnesses.

show abstract

Injuries in children and adolescents with psychiatric disorders

Cited by 11 publications

References 44 publications

Risk of Self-harm in Children and Adults With Autism Spectrum Disorder

Risk of Self-harm in Children and Adults With Autism Spectrum Disorder

Children’s advocacy centre fails to respond to dental, mental and physical ill‐health in abused children

Self-Harm Events and Suicide Deaths Among Autistic Individuals in Ontario, Canada

Contact Info

Product

Resources

About