Suicide and Self-Harm in Children and Adolescents Admitted to PICUs in the United States.

Journal Article (Journal Article;Multicenter Study)

OBJECTIVES: To characterize the epidemiology of children and adolescents admitted for deliberate self-harm to PICUs in the United States by examining patient demographics, diagnoses, modes of self-harm, and outcomes. DESIGN: Descriptive analysis of a large, multicenter, quality-controlled database. SETTING: The 137 PICUs participating in the Virtual Pediatric Systems database during the study period. PATIENTS: Children between 6 and 18 years old admitted to a participating PICU from January 1, 2009, to December 31, 2017, with a diagnosis involving deliberate self-harm or a suicide attempt. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 9,197 admissions for self-harm, females accounted for 6,740 (73.3%), whereas males incurred 174 of the 284 deaths (61.3%). Admissions for self-harm doubled over the study period (0.56% in 2009 vs 1.13% in 2017), with an increase observed across every age group. After PICU care, most patients were transferred to a general care floor (51.1%) or to a psychiatric rehabilitation facility (31.8%). Intentional drug ingestion (84%) was the most common mode of self-harm but was associated with less than 1% of the fatalities. Asphyxia/hanging or firearms were a factor in 411 (4.5%) and 106 (1.2%) of the admissions but were associated with 117 (28.5%) and 55 (51.9%) of the deaths, respectively. CONCLUSIONS: PICU admissions due to self-harm increased for all age groups during the study period. Females accounted for most of these admissions, whereas males accrued most of the in-hospital deaths. Intentional drug ingestion was the most common mode of self-harm and was rarely fatal, whereas asphyxia and firearms were the mechanisms associated with the highest mortality.

Full Text

Duke Authors

Cited Authors

  • McCluskey, CK; Klein, MJ; Steward, SC; Rotta, AT

Published Date

  • January 1, 2022

Published In

Volume / Issue

  • 23 / 1

Start / End Page

  • e66 - e70

PubMed ID

  • 34560771

International Standard Serial Number (ISSN)

  • 1529-7535

Digital Object Identifier (DOI)

  • 10.1097/PCC.0000000000002836


  • eng

Conference Location

  • United States