Sex Differences in Suicides among Children and Youth: The Potential Impact of Help-Seeking Behaviour

Rhodes, Anne E.; Khan, Saba; Boyle, Michael H.; Tonmyr, Lil; Wekerle, Christine; Goodman, Deborah; Bethell, Jennifer; Leslie, Bruce; Lu, Hong; Manion, Ian

doi:10.1177/070674371305800504

Cited by 53 publications

(62 citation statements)

References 28 publications

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“…As such, additional unidentified factors appear to be contributing to the trends in youth. [22][23][24] Key study limitations are the data, which only captured SRB among youth who present to hospital, did not identify intent, 4 and precluded more detail on SRB methods. Among girls, suicidal intent has been found more common among those who self-poison than self-cut.…”

Section: Discussionmentioning

confidence: 99%

Time Trends in Medically Serious Suicide-Related Behaviours in Boys and Girls

Rhodes

Skinner

2014

Can J Psychiatry

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Objective: To determine whether emergency department (ED) presentations for suiciderelated behaviours (SRBs) in boys and girls were identified as more clinically acute in the ED in the period after the regulatory warnings against prescribing antidepressants and during the global economic recession, and to characterize the medical severity of SRBs among boys and girls to aid surveillance activities. Results:In both boys and girls, high acuity events were 50% greater after FY 2004 than before, regardless of subsequent admission, and most common among boys and girls who self-poisoned. In girls, opposing linear trends before and after FY 2004 were observed in the proportion of self-poisonings and cut (or) pierce SRB methods. Throughout the study period, there was a linear decline in the proportion of boys presenting to the ED with other methods. Conclusions:The previously reported increase in hospital admissions after the warnings and during the recession is unlikely artifactual. An equivalent increase in high acuity events was also evident among those not subsequently admitted. The reasons for varying responses in boys and girls by SRB method warrant further study. W W W Tendances temporelles de comportements médicalement sérieux liés au suicide chez les garçons et les fillesObjectif : Déterminer si les présentations au service d'urgence (SU) pour des comportements liés au suicide (CLS) chez les garçons et les filles ont été identifiées comme étant plus cliniquement aiguës au SU dans la période qui a suivi les avertissements réglementaires contre la prescription d'antidépresseurs et durant la récession économique mondiale, et caractériser la gravité médicale des CLS chez les garçons et les filles pour aider les activités de surveillance.

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Section: Discussionmentioning

confidence: 99%

Time Trends in Medically Serious Suicide-Related Behaviours in Boys and Girls

Rhodes

Skinner

2014

Can J Psychiatry

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“…12 PCCs prescribe most pediatric psychoactive medications 13 and up to 80% of youth who die by suicide were seen by their PCC or an outpatient physician in the year prior to their death. 8,9 The American Academy of Pediatrics (AAP) recognizes suicide prevention as a priority for pediatricians 14 and has endorsed guidelines for the care of depressed youth in primary care. 15,16 …”

Section: Public Health Approach To Youth Suicide Preventionmentioning

confidence: 99%

“…2 Moreover, up to 50% of youth who die by suicide present to the ED within the year preceding death. 8 …”

Section: Public Health Approach To Youth Suicide Preventionmentioning

confidence: 99%

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Prioritizing Research to Reduce Youth Suicide and Suicidal Behavior

Bridge

Horowitz

Fontanella

et al. 2014

American Journal of Preventive Medicine

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The goal of the National Action Alliance for Suicide Prevention (Action Alliance) is to reduce suicide and suicide attempts in the U.S. by 40% in the next decade. In this paper, a public health approach is applied to suicide prevention to illustrate how reductions in youth suicide and suicidal behavior might be achieved by prioritizing research in two areas: (1) increasing access to primary care–based behavioral health interventions for depressed youth; and (2) improving continuity of care for youth who present to emergency departments after a suicide attempt. Finally, some scientific, clinical, and methodologic breakthroughs needed to achieve rapid, substantial, and sustained reductions in youth suicide and suicidal behavior are discussed.

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“…Some potential explanations for the preponderance of suicide among male subjects include sex-related differences in mental health treatment-seeking behavior, 39 self-harm methods, 40 and pubertal development. 41 Because the risk for repeated self-harm was greater for female subjects than male subjects, higher lethality of male than female self-harm events likely contributes to the preponderance of suicides by male subjects after self-harm.…”

Section: Figurementioning

confidence: 99%

Suicide After Deliberate Self-Harm in Adolescents and Young Adults

et al. 2018

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OBJECTIVES:Among adolescents and young adults with nonfatal self-harm, our objective is to identify risk factors for repeated nonfatal self-harm and suicide death over the following year. METHODS:A national cohort of patients in the Medicaid program, aged 12 to 24 years (n = 32 395), was followed for up to 1 year after self-harm. Cause of death information was obtained from the National Death Index. Repeat self-harm per 1000 person-years and suicide deaths per 100 000 person-years were determined. Hazard ratios (HRs) of repeat self-harm and suicide were estimated by Cox proportional hazard models. Suicide standardized mortality rate ratios were derived by comparison with demographically matched general population controls. RESULTS:The 12-month suicide standardized mortality rate ratio after self-harm was significantly higher for adolescents (46.0, 95% confidence interval [CI]: 29.9-67.9) than young adults (19.2, 95% CI: 12.7-28.0). Hazards of suicide after self-harm were significantly higher for American Indians and Alaskan natives than non-Hispanic white patients (HR: 4.69, 95% CI: 2.41-9.13) and for self-harm patients who initially used violent methods (HR: 18.04, 95% CI: 9.92-32.80), especially firearms (HR: 35.73, 95% CI: 15.42-82.79), compared with nonviolent self-harm methods (1.00, reference). The hazards of repeat self-harm were higher for female subjects than male subjects (HR: 1.25, 95% CI: 1.18-1.33); patients with personality disorders (HR: 1.55, 95% CI: 1.42-1.69); and patients whose initial self-harm was treated in an inpatient setting (HR: 1.65, 95% CI: 1.49-1.83) compared with an emergency department (HR: 0.62, 95% CI: 0.55-0.69) or outpatient (1.00, reference) setting. CONCLUSIONS:After nonfatal self-harm, adolescents and young adults were at markedly elevated risk of suicide. Among these high-risk patients, those who used violent self-harm methods, particularly firearms, were at especially high risk underscoring the importance of follow-up care to help ensure their safety.abstract

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Sex Differences in Suicides among Children and Youth: The Potential Impact of Help-Seeking Behaviour

Cited by 53 publications

References 28 publications

Time Trends in Medically Serious Suicide-Related Behaviours in Boys and Girls

Time Trends in Medically Serious Suicide-Related Behaviours in Boys and Girls

Prioritizing Research to Reduce Youth Suicide and Suicidal Behavior

Suicide After Deliberate Self-Harm in Adolescents and Young Adults

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