Study Identifies Children and Adolescents Who Show Varying Risks of Self-harm

A study, “Characteristics Associated with Serious Self-Harm Events in Children and Adolescents,” published in the June 2023 Pediatrics describes four distinct profiles of psychiatric comorbidity that can help identify children and teens at elevated risk for self-harm events, such as suicide attempts or self-injury. The study, published online May 1, identified 1,098 children hospitalized with a neuropsychiatric event at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, TN, and Children's Hospital of Colorado in Aurora, CO. Of those hospitalized, 406 (37%) were diagnosed with a self-harm event. Researchers identified categories of children and teens at low risk, moderate risk, high risk and very high risk for serious self-harm. The very high-risk profile was comprised of male adolescents age 10-13 with ADHD, bipolar disorder, autism spectrum disorder, and other developmental disorders. The low risk profile was comprised of children ages 5 to 9 who had a non-mental health diagnosis and an absence of mood disorders, behavioral disorders, psychotic disorders, developmental disorders, and trauma or substance-related disorders. Those determined to be at high risk were female adolescents ages 14 to 17 with depression and anxiety in conjunction with substance- and trauma- related disorders. Personality and eating disorders were also significant for this profile. Those at moderate risk had a significant absence of depressive disorders, suggesting that these disorders play a major role in driving the risk of suicidality. The authors note that studies show the gap in suicide rates among male and female young adolescents has been narrowing. The authors suggest more research is needed but say these profiles can be used to inform clinical decisions by allowing providers to better assess overall risk of self-harm in children and adolescents.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.