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Identifying undiagnosed high-risk suicidality cases through comorbidity-adjusted risk modeling.

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Pediatric suicidality is underreported. This study used ICD-10 codes to identify mental health comorbidities and found propensity score matching effective for identifying at-risk youth.

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Area of Science:

  • Pediatric Emergency Medicine
  • Mental Health Research
  • Health Informatics

Background:

  • Pediatric suicidality is a critical public health issue, underreported and posing challenges for intervention.
  • Identifying at-risk pediatric populations is crucial for effective prevention and resource allocation.
  • Understanding comorbidities associated with suicidality aids in early detection and targeted support.

Purpose of the Study:

  • To determine the prevalence of mental health comorbidities linked to pediatric suicidality.
  • To utilize propensity score matching to identify undiagnosed high-risk pediatric suicidality cases.
  • To enhance the accuracy of identifying youth experiencing suicidal ideation, self-harm, or attempts.

Main Methods:

  • Analysis of ICD-10 diagnosis codes for pediatric patients (ages 6-18) in an emergency department setting.
  • Defined suicidality cases including ideation, self-harm, and attempt subtypes.
  • Employed propensity score matching to link diagnosed suicidality cohorts with undiagnosed at-risk individuals.

Main Results:

  • 2.9% of emergency department encounters met the suicidality case definition.
  • Identified 55 significant comorbidities, with many not aligning with current diagnostic codes.
  • High probabilities of suicidality diagnosis were associated with personality disorder, gender dysphoria, bipolar disorder, depression, and schizophrenia spectrum disorders.
  • Propensity matching correctly identified 53.4% of true positive suicidality cases.

Conclusions:

  • Propensity score matching effectively identifies undiagnosed pediatric suicidality cases.
  • Comorbidity profiles of matched cases closely resemble those with diagnosed suicidality.
  • This method offers a valuable tool for improving the identification and support of at-risk youth.