Identifying Undiagnosed High-Risk Suicidality Cases by Matching Patients With a Similar Comorbidity Burden:...

Area of Science:

• Pediatric emergency medicine
• Mental health research
• Health informatics

Background:

• Suicide is a leading cause of death in children and adolescents.
• Underreporting of pediatric suicidality challenges intervention and prevention.
• Identifying at-risk populations is crucial for resource allocation and research.

Purpose of the Study:

• To determine the prevalence of mental health comorbidities in pediatric suicidality.
• To identify undiagnosed high-risk pediatric suicidality cases using comorbidity matching.

Main Methods:

• Analysis of electronic health records (EHRs) for patients aged 6-18.
• Utilized International Classification of Diseases, 10th Revision (ICD-10) codes for suicidality subtypes.
• Employed propensity score matching (PSM) with significant comorbidities and demographics.

Main Results:

• 2.9% of emergency department encounters met suicidality criteria.
• Significant comorbidities were identified for 55 ICD-10 codes.
• PSM identified unrecognized suicidality in 53.4% of non-cases, with high-risk associations for personality disorders, gender dysphoria, bipolar disorder, depression, and schizophrenia spectrum disorders.

Conclusions:

• Propensity score matching (PSM) effectively identifies pediatric suicidality cases lacking explicit ICD-10 suicidality codes.
• Comorbidity profiling enhances the detection of underdiagnosed pediatric suicidality.