Time Trends in Suicide-Related Behaviours in Girls and Boys

Rhodes, Anne E.; Bethell, Jennifer; Carlisle, Corine; Rosychuk, Rhonda J.; Lu, Hong; Newton, Amanda S

doi:10.1177/070674371405900307

Cited by 22 publications

(33 citation statements)

References 42 publications

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“…46,47 Encouragingly, results from this study suggest that suicidal ideation and suicide attempts may be declining. This finding is supported by studies that reported a recent decline in suicide rates [48][49][50] and attempts 51 among Canadian and American youth. Though there is no conclusive evidence for the efficacy of various efforts in preventing suicide, 52 some strategies, including physician education and certain school-based strategies, show promise in reducing suicidal behaviours.…”

Section: Resultssupporting

confidence: 77%

Time trends in symptoms of mental illness in children and adolescents in Canada

McMartin

Kingsbury

Dykxhoorn

et al. 2014

CMAJ

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Interpretation:With the exception of hyperactivity, the prevalence of symptoms of mental illness in Canadian children and adolescents has remained relatively stable from 1994/95 to 2008/09. Conflicting reports of escalating rates of mental illness in Canada may be explained by differing methodologies between studies, an increase in treatment-seeking behaviour, or changes in diagnostic criteria or practices. AbstractResearch CMAJ, December 9, 2014, 186(18) E673 Methods Study designThis study used data from the National Longitudinal Survey of Children and Youth, which involves a population-based cohort of Canadian children and adolescents followed prospectively every 2 years by Statistics Canada since 1994/95. 14 The cohort is considered nationally representative, with the exception of children living on First Nations reserves or Crown lands, in institutions and in some remote regions. This study was designed to collect information about multiple aspects of child health and development. The follow-up rate for the National Longitudinal Survey of Children and Youth from cycle 1 (1994/95) to cycle 8 (2008/2009) was 61%.15 Further details about the cohort, including study design and response rates (mostly above 80% at each wave), are described elsewhere. 14,15 The survey included numerous assessments related to child and adolescent mental health. The behaviour scale was adapted from questionnaires used in the Montreal Longitudinal Survey and the Ontario Child Health Study, which were designed to identify children who would most likely qualify for a psychiatric diagnosis based on symptom criteria for the revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders. 16 This scale has been used in previous studies of child and adolescent adjustment, and has shown good psychometric properties. 17,18 In each cycle, participants aged 10 years or older were asked to self-report the frequency of various feelings and behaviours in the past week, with 3 possible responses ranging from "never or not true" to "often or very true." Each item was assigned a score of 0 to 2 (higher scores indicating a greater degree of mental health problems). Questionnaires were completed on paper, at home in a private setting, and sealed in envelopes to ensure confidentiality.Composite scores were created by summing item scores on each of 4 subscales relevant to adolescent mental illness: conduct disorder (6 items, e.g., "I kick or hit other people my age"), hyperactivity (7 items, e.g., "I am impulsive, I act without thinking"), indirect aggression (5 items, e.g., "When I am mad at someone, I say bad things behind his/her back"), and symptoms of depression/anxiety (7 items, e.g., "I am not as happy as other people my age" and "I worry a lot"). 19 The same items were collected at each cycle, with the exception of 1 hyperactivity item and 1 depression/anxiety item, which were dropped in cycle 4. In the interest of comparability over time, these items were not included in composite scores. All items comprising the final scale...

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Section: Resultssupporting

confidence: 77%

Time trends in symptoms of mental illness in children and adolescents in Canada

McMartin

Kingsbury

Dykxhoorn

et al. 2014

CMAJ

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“…SRBs begin in youth, with those presenting to the ED having an elevated risk for repetition and suicide. 2,3 In a prior study, 4 5 We also observed that among youth with an ED SRB index event, the proportion with a subsequent inpatient stay increased by about one-third between FYs 2005 to 2010, in boys and girls. This latter finding implied not only that the decline in ED SRB presentations was halted by FY 2006 but also that some youth experienced an increase in SRB medical severity.…”

Section: Limitationsmentioning

confidence: 52%

“…SRB method was defined according to the ICD-10-CA code(s) as selfpoisoning only (X60 to X69); cut or pierce only (X78), or "other only" (X70 to X77 and X79 to X84) or multiple: more than 1 of these methods. 20 As multiple methods were infrequent in children and "other only" methods infrequent in girls, 4 these sex distributions are not described further. …”

Section: Methodsmentioning

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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“…10 Several studies have demonstrated, however, that receipt of follow-up services does not occur for the majority of young people, 11,12 and that certain sociodemographics-lower income neighbourhoods, gender/sex, age, ethnicity-are reflected in higher ED visit rates and lower rates of post-ED follow-up after emergency care for self-harm. 8,[11][12][13] Whether these sociodemographic trends for self-harm are reflected among Canadian children and youth is not well understood.…”

Section: Introductionmentioning

confidence: 99%

“…8,13 Disparities in ED visit rates for mental health care and post-ED physician contact across Alberta have been reported for First Nations children and children from families receiving social assistance; however, data specific to self-harm were not reported. 14 A better understanding of any disparities amongst Canadian young people who deliberately self-harm could be helpful in a number of ways.…”

Section: Introductionmentioning

confidence: 99%

Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta

Newton

Tsang

Rosychuk

2015

CJEM

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Objective: To examine sociodemographic variations among children <18 years in (1) rates of self-harm visits to emergency departments (EDs) and (2) physician follow-up after the selfharm visit in Alberta. Methods: A retrospective, population-based cohort (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011) of ED visits for self-harm by individuals <18 years was conducted using administrative databases from Alberta, Canada. Individuals were grouped by First Nations status or type of health care premium subsidy (family receipt of government subsidy, human services program subsidy, no subsidy received). Visits from 104 EDs were summarized by crude and directly standardized visit rates (DSVRs) per 100,000 individuals. Kaplan-Meier estimates for median estimated time to physician follow-up were calculated with 95% confidence intervals (CIs). Results: During the study period, visit rates decreased with the exception of children from families receiving government-sponsored program subsidy (DSVRs 163/ 100,000 to 250/100,000; p = 0.032). First Nations children had disproportionately fewer follow-up visits compared to other children. The median time to follow-up for First Nations children was 39 days (95% CI: 32, 48) compared to 16 days for children from families receiving no subsidy (95% CI: 14, 19), who had the shortest follow-up time after an ED visit. Conclusions: Sociodemographic differences were evident in ED visit rates as well as the number of and time to physician followup visit. The disparities experienced by First Nations children in the follow-up period highlight an opportunity for culturallygrounded risk and needs assessment in the ED to determine and facilitate timely and appropriate follow-up care.

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Time Trends in Suicide-Related Behaviours in Girls and Boys

Abstract: While the decline in ED SRB rates to FY 2006/07 is encouraging, the lack of decline thereafter and an increase in subsequent admissions merits ongoing monitoring and evaluation.

Cited by 22 publications

References 42 publications

Time trends in symptoms of mental illness in children and adolescents in Canada

Time trends in symptoms of mental illness in children and adolescents in Canada

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

Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta

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