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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引用次数: 0
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.
Suzanne Rybczynski, Taylor C Ryan, Holly C Wilcox, Kathryn Van Eck, Mary Cwik, Roma A Vasa, Robert L Findling, Keith Slifer, Daniel Kleiner, Paul H Lipkin
Shayla A. Sullivant MD (is Child and Adolescent Psychiatrist, Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, Missouri, and Associate Professor of Pediatrics, University of Missouri–Kansas City (UMKC) School of Medicine.), Debby Brookstein MSW, LCSW, LSCSW (is Senior Director of Social Work, Children's Mercy Kansas City.), Michelle Camerer LCSW, LMSW, LSCSW (is Social Work, Manager Children's Mercy Kansas City.), Joan Benson MSN, RN-BC, CPN (is Director, Clinical Informatics and Practice, Children's Mercy Kansas City.), Mark Connelly PhD (is Director of Research, Developmental and Behavioral Health, Children's Mercy Kansas City, and Professor of Pediatrics UMKC School of Medicine.), John Lantos MD (is Director, Bioethics Center, Children's Mercy Kansas City.), Karen Cox PhD, RN, FAAN (is President, Chamberlain University, Chicago, Illinois.), Kathy Goggin PhD (is Director, Division of Health Services and Outcomes Research, Children's Mercy Kansas City, and Professor, UMKC Schools of Medicine and Pharmacy)
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.