التفاصيل البيبلوغرافية
| العنوان: |
Predictors of self-harm emergency department visits in adolescents: A statewide longitudinal study. |
| المؤلفون: |
Goldman-Mellor, Sidra1 (AUTHOR) sgoldman-mellor@ucmerced.edu, Kwan, Kevin1 (AUTHOR) kkwan2@ucmerced.edu, Boyajian, Jonathan1 (AUTHOR) jboyajian@ucmerced.edu, Gruenewald, Paul1 (AUTHOR) paul@prev.org, Brown, Paul1 (AUTHOR) pbrown3@ucmerced.edu, Wiebe, Deborah1 (AUTHOR) dwiebe@ucmerced.edu, Cerdá, Magdalena1 (AUTHOR) cerda@ucdavis.edu |
| المصدر: |
General Hospital Psychiatry. Jan2019, Vol. 56, p28-35. 8p. |
| مصطلحات موضوعية: |
*HOSPITAL emergency services, *LONGITUDINAL method, *MEDICAID, *MEDICAL appointments, *MINORITIES, *RESIDENTIAL mobility, *SELF-injurious behavior, *RESIDENTIAL patterns, *SOCIOECONOMIC factors, *RETROSPECTIVE studies, *CASE-control method, *PSYCHOLOGICAL factors, *ADOLESCENCE |
| مصطلحات جغرافية: |
CALIFORNIA |
| مستخلص: |
Abstract Objective This study investigated patient- and area-level characteristics associated with adolescent emergency department (ED) patients' risk of subsequent ED visits for self-harm. Method Retrospective analysis of adolescent patients presenting to a California ED in 2010 (n = 480,706) was conducted using statewide, all-payer, individually linkable administrative data. We examined associations between multiple predictors of interest (patient sociodemographic factors, prior ED utilization, and residential mobility; and area-level characteristics) and odds of a self-harm ED visit in 2010. Patients with any self-harm in 2010 were followed up over several years to assess predictors of recurrent self-harm. Results Self-harm patients (n = 5539) were significantly more likely than control patients (n = 16,617) to have prior histories of ED utilization, particularly for mental health problems, substance abuse, and injuries. Residential mobility also increased risk of self-harm, but racial/ethnic minority status and residence in a disadvantaged zipcode decreased risk. Five-year cumulative incidence of recurrent self-harm was 19.3%. Admission as an inpatient at index visit, Medicaid insurance, and prior ED utilization for psychiatric problems or injury all increased recurrent self-harm risk. Conclusions A range of patient- and area-level characteristics observable in ED settings are associated with risk for subsequent self-harm among adolescents, suggesting new targets for intervention in this clinical context. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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