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Childhood adversity, mental health and suicide (CHASE): a methods protocol for a longitudinal case-control linked
N Dougall1, J Savinc1, M Maxwell2
1School of Health & Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK.
International Journal of Population Data Science
|July 7, 2021
Summary
Childhood adversity is linked to suicide risk. This study harmonizes hospital data to identify patterns and inform early interventions for at-risk youth. Understanding these links is crucial for suicide prevention efforts.
Area of Science:
- Public Health
- Epidemiology
- Data Science
Background:
- Suicide rates, particularly among young people, have increased significantly.
- Childhood adversity is a known predictor of poor social and health outcomes, including suicide.
- Current suicide prevention strategies lack effectiveness, highlighting the need for targeted interventions.
Purpose of the Study:
- To develop methodology for harmonizing lifespan hospital contact data for childhood adversity, mental health, and suicidal behavior.
- To inform the focus of interventions, prioritization of trauma-informed approaches, and adaptation of support systems.
- To identify early life risk factors and hospital contact patterns associated with suicide.
Main Methods:
- A case-control study design using Scottish hospital data (physical health, mental health, maternity, death records).
- Linking data via the Community Health Index for individuals aged 10-34 who died by suicide and a matched control population.
- Harmonizing International Classification of Disease (ICD) codes for childhood adversity, mental health, and suicidal behavior across different versions (ICD9-CM, ICD9, ICD10-CM, ICD10).
Main Results:
- Harmonized ICD categories for childhood adversity were developed, classified as maltreatment/violence-related or suggestive of maltreatment.
- Clinical Classifications Software codes were used to operationalize mental health diagnoses.
- Semi-automatic harmonization of lifespan ICD categories required significant manual coding and cross-mapping.
Conclusions:
- There is a significant lack of evidence regarding pre-suicide hospital contact patterns.
- This study provides methods and harmonized ICD codes to analyze lifespan hospital contacts related to childhood adversity.
- The findings will aid in understanding hospital contact patterns for childhood adversity that come to the attention of practitioners, informing targeted interventions.
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