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Suicide attempt and self-harm among hospitalized children in Japan: A nationwide inpatient database study
Sachiko Kita1,2,3, Kojiro Morita4,5, Hideaki Watanabe6
1Department of Psychological Studies, Temple University of Japan Campus, Tokyo, Japan.
Insights
This study analyzed 1,704 children hospitalized for suicide attempts and self-harm, revealing significant gender and age differences in methods and care. Findings highlight the need for tailored interventions to prevent child suicide.
Area of Science:
- Pediatrics
- Psychiatry
- Public Health
Background:
- Childhood suicide attempts and self-harm represent a critical public health concern.
- Understanding demographic and clinical variations is essential for effective prevention strategies.
Purpose of the Study:
- To characterize suicide attempts and self-harm in children (7-17 years).
- To investigate gender and age-specific differences in methods, comorbidities, and clinical trajectories.
- To inform the development of targeted interventions and health policies.
Main Methods:
- Nationwide retrospective cross-sectional study using the Japanese Diagnosis Procedure Combination inpatient database (2016-2017).
- Analysis of 1,704 children hospitalized for suicide attempts and self-harm.
- Examination of patient characteristics, suicide methods, comorbid psychiatric disorders, and healthcare utilization.
Main Results:
- Overdose was the most common method (49.9%).
- 66.0% lacked a mental illness diagnosis, and 56.3% received no psychiatric/psychological care.
- Boys and younger children (7-12 years) were more likely to use high-lethality methods and experience in-hospital mortality.
- Girls were more likely to use low-lethality methods and receive psychiatric intervention.
Conclusions:
- Significant gender and age disparities exist in child suicide attempts and self-harm.
- Lack of mental health diagnosis and intervention highlights critical gaps in care.
- Development of gender and age-sensitive policies and interventions is crucial for child suicide prevention.
Abstract:
This study aims to delineate the characteristics and clinical trajectories of suicide attempts and self-harm, and its gender and age differences among children. This nationwide retrospective cross-sectional study utilized data extracted from the Japanese Diagnosis Procedure Combination inpatient database spanning 2016 to 2017. Children aged 7-17 years admitted to acute care hospitals for suicide attempts and self-harm, were identified. Patient characteristics included age, gender, suicide method, and comorbid psychiatric disorders. Trajectory information included the duration of hospital stay, admission ward, psychiatric/psychological interventions, in-hospital mortality, and healthcare expenditure. Data analysis encompassed 1,704 children hospitalized for suicide attempts and self-harm. Among these, 49.4% were junior high school age, 69.0% for female, and 28.4% for underweight. Overdose emerged as the most prevalent method for suicide attempts and self-harm (49.9%). Notably, 66.0% did not receive a diagnosis of any mental illness, and 56.3% did not undergo psychiatric/psychological care during their hospitalization. Boys were more likely to use high-lethality suicide methods, such as hanging (p < 0.001), and die during hospitalization (p < 0.001). Conversely, girls were more likely to use low-lethality suicide methods, such as drug overdose (p < 0.001), and receive psychiatric/psychological intervention during hospitalization (p = 0.015). Children aged 7-12 years were more likely to use high-lethality suicide methods, such as hanging (p < 0.001), and be diagnosed with attention-deficit/hyperactivity disorder (p < 0.001) and less likely to receive psychiatric/psychological intervention (p = 0.005) compared with other age groups. These findings suggest the importance of developing gender and age sensitive health policies, systems, and interventions to prevent child suicide.