Universal Suicide Risk Screening in Pediatric Neurologic, Developmental, and Behavioral Clinics

IF 3 3区 医学 Q1 PEDIATRICS Academic Pediatrics Pub Date : 2024-12-17 DOI:10.1016/j.acap.2024.102623
Suzanne Rybczynski MD, MSHCM , Allison Gornik PhD , Benjamin Joffe Schindel MD, MPH , Mwuese Ngur BA , Teresa Matte-Ramsdell BS , Carmen Lopez-Arvizu MD , Paul H. Lipkin MD , T. Andrew Zabel PhD
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Abstract

Objective

Suicidal thoughts and behaviors in youth have been increasing over the last 30 years, resulting in recommendations to screen for suicide risk. Our aim was to evaluate suicide risk screenings in children during outpatient care at a specialty care facility for those with neurologic, developmental, and behavioral disorders (NDBDs).

Methods

This cross-sectional, retrospective study utilized suicide screening data from the Ask Suicide-Screening Questions tool administered to children attending initial outpatient visits at medical, behavioral health, or autism specialty clinics serving individuals with NDBDs. Primary outcomes included whether screening occurred or was declined, and if it yielded elevated risk for suicide. Predictive factors were examined.

Results

In total, 15,462 children aged 8 to 17 (38.4% female; 47.7% White, 26.0% Black; 21.0% Medicaid) were offered screening as part of routine care. Overall, 10,970 children underwent screening; 4492 (29.1%) declined. The probability of declined screenings was greater if children were younger, male, attended a medical clinic appointment and were offered the screening prior to the COVID-19 pandemic. The overall rate of positive screening was 10.3%. Children as young as age 8 screened positive in all settings. Positive screening rates in medical, behavioral health, and autism specialty clinics were 7.9%, 12.2%, and 12.7%, respectively. Screenings were more likely to be positive for children who were older, female, self-reported rather than caregiver-reported, and occurring within a behavioral health or autism specialty clinic.

Conclusions

Suicide risk was identified in children across all pediatric programs, indicating strong support for universal suicide screening of children and youth in pediatric settings.
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在儿科神经、发育和行为诊所普及自杀风险筛查。
背景和目的:在过去的三十年中,青少年的自杀想法和行为一直在增加,因此建议筛查自杀风险。我们的目的是评估在一家专门护理机构门诊治疗患有神经、发育和行为障碍(NDBD)的儿童的自杀风险筛查。方法:这项横断面、回顾性研究利用自杀筛查数据,这些数据来自“询问自杀筛查问题”工具,该工具对在医疗、心理健康或自闭症专科诊所接受首次门诊就诊的儿童进行管理,这些诊所为NDBD患者提供服务。主要结果包括筛查是否发生或拒绝,以及筛查是否会增加自杀风险。研究了预测因素。结果:8 ~ 17岁儿童15462例,其中女性38.4%;白人47.7%,黑人26.0%;21.0%的医疗补助)作为常规护理的一部分提供筛查。总共有10970名儿童接受了筛查;减少了4492件(29.1%)。如果儿童年龄较小,男性,参加过医疗诊所预约,并且在COVID-19大流行之前接受筛查,则拒绝筛查的可能性更大。总体阳性筛查率为10.3%。年仅8岁的儿童在所有环境中筛查呈阳性。医学、心理健康和自闭症专科诊所的阳性筛查率分别为7.9%、12.2%和12.7%。对于年龄较大、女性、自我报告而非照顾者报告、在行为健康或自闭症专科诊所进行的儿童,筛查更有可能是阳性的。结论:在所有儿科项目中都发现了儿童的自杀风险,这表明在儿科机构中对儿童和青少年进行普遍的自杀筛查是强有力的支持。
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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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