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Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017

Nadine Dougall, Jan Savinc Orcid Logo, Margaret Maxwell, Thanos Karatzias Orcid Logo, Rory C. O'Connor, Brian Williams, Ann John Orcid Logo, Helen Cheyne, Claire Fyvie, Jonathan I. Bisson Orcid Logo, Carina Hibberd, Susan Abbott-Smith, Liz Nolan, Jennifer Murray

BJPsych Open, Volume: 10, Issue: 4

Swansea University Author: Ann John Orcid Logo

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DOI (Published version): 10.1192/bjo.2024.69

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BackgroundChildhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.AimTo determine associations between hospital admissions for childhood adversity and mental health in childr...

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Published in: BJPsych Open
ISSN: 2056-4724
Published: Published by Cambridge University Press on behalf of Royal College of Psychiatrists Royal College of Psychiatrists 2024
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>66516</id><entry>2024-05-28</entry><title>Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017</title><swanseaauthors><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-05-28</date><deptcode>MEDS</deptcode><abstract>BackgroundChildhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.AimTo determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.MethodPopulation-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).ResultsRecords were extracted for 2477 ‘cases’ and 24 777 ‘controls’; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10–17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4–3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7–7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions &lt;18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aORmale = 8.17 (95% CI, 5.02–13.29), aORfemale = 15.08 (95% CI, 8.07–28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aORmale = 1.90 (95% CI, 1.64–2.21), aORfemale = 2.65 (95% CI, 1.94–3.62), and each mental health admission by aORmale = 2.06 (95% CI, 1.81–2.34), aORfemale = 1.78 (95% CI, 1.50–2.10).ConclusionsOur lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential ‘at-risk’ adolescents to prevent future suicidal acts, especially those in general hospitals.</abstract><type>Journal Article</type><journal>BJPsych Open</journal><volume>10</volume><journalNumber>4</journalNumber><paginationStart/><paginationEnd/><publisher>Royal College of Psychiatrists</publisher><placeOfPublication>Published by Cambridge University Press on behalf of Royal College of Psychiatrists</placeOfPublication><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2056-4724</issnElectronic><keywords>Childhood adversity; Adverse childhood experiences; Mental Health; Self-harm; Suicide</keywords><publishedDay>1</publishedDay><publishedMonth>7</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-07-01</publishedDate><doi>10.1192/bjo.2024.69</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>The project was funded by the Chief Scientist Office of the Scottish Government (HIPS/17/48). The funder does not have a role in the design or conduct of the study.</funders><projectreference>(HIPS/17/48)</projectreference><lastEdited>2024-06-17T12:58:35.1369744</lastEdited><Created>2024-05-28T09:49:37.5091351</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Nadine</firstname><surname>Dougall</surname><order>1</order></author><author><firstname>Jan</firstname><surname>Savinc</surname><orcid>0000-0002-0894-8571</orcid><order>2</order></author><author><firstname>Margaret</firstname><surname>Maxwell</surname><order>3</order></author><author><firstname>Thanos</firstname><surname>Karatzias</surname><orcid>0000-0002-3002-0630</orcid><order>4</order></author><author><firstname>Rory C.</firstname><surname>O'Connor</surname><order>5</order></author><author><firstname>Brian</firstname><surname>Williams</surname><order>6</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>7</order></author><author><firstname>Helen</firstname><surname>Cheyne</surname><order>8</order></author><author><firstname>Claire</firstname><surname>Fyvie</surname><order>9</order></author><author><firstname>Jonathan I.</firstname><surname>Bisson</surname><orcid>0000-0001-5170-1243</orcid><order>10</order></author><author><firstname>Carina</firstname><surname>Hibberd</surname><order>11</order></author><author><firstname>Susan</firstname><surname>Abbott-Smith</surname><order>12</order></author><author><firstname>Liz</firstname><surname>Nolan</surname><order>13</order></author><author><firstname>Jennifer</firstname><surname>Murray</surname><order>14</order></author></authors><documents><document><filename>66516__30571__9e42c8ca30bd4475ba91484ddd6852b4.pdf</filename><originalFilename>66516.pdf</originalFilename><uploaded>2024-06-07T14:49:12.7386594</uploaded><type>Output</type><contentLength>498804</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Author(s), 2024. 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spelling v2 66516 2024-05-28 Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017 ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2024-05-28 MEDS BackgroundChildhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.AimTo determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.MethodPopulation-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).ResultsRecords were extracted for 2477 ‘cases’ and 24 777 ‘controls’; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10–17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4–3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7–7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aORmale = 8.17 (95% CI, 5.02–13.29), aORfemale = 15.08 (95% CI, 8.07–28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aORmale = 1.90 (95% CI, 1.64–2.21), aORfemale = 2.65 (95% CI, 1.94–3.62), and each mental health admission by aORmale = 2.06 (95% CI, 1.81–2.34), aORfemale = 1.78 (95% CI, 1.50–2.10).ConclusionsOur lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential ‘at-risk’ adolescents to prevent future suicidal acts, especially those in general hospitals. Journal Article BJPsych Open 10 4 Royal College of Psychiatrists Published by Cambridge University Press on behalf of Royal College of Psychiatrists 2056-4724 Childhood adversity; Adverse childhood experiences; Mental Health; Self-harm; Suicide 1 7 2024 2024-07-01 10.1192/bjo.2024.69 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee The project was funded by the Chief Scientist Office of the Scottish Government (HIPS/17/48). The funder does not have a role in the design or conduct of the study. (HIPS/17/48) 2024-06-17T12:58:35.1369744 2024-05-28T09:49:37.5091351 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Nadine Dougall 1 Jan Savinc 0000-0002-0894-8571 2 Margaret Maxwell 3 Thanos Karatzias 0000-0002-3002-0630 4 Rory C. O'Connor 5 Brian Williams 6 Ann John 0000-0002-5657-6995 7 Helen Cheyne 8 Claire Fyvie 9 Jonathan I. Bisson 0000-0001-5170-1243 10 Carina Hibberd 11 Susan Abbott-Smith 12 Liz Nolan 13 Jennifer Murray 14 66516__30571__9e42c8ca30bd4475ba91484ddd6852b4.pdf 66516.pdf 2024-06-07T14:49:12.7386594 Output 498804 application/pdf Version of Record true © The Author(s), 2024. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence. true eng http://creativecommons.org/licenses/by/4.0/
title Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017
spellingShingle Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017
Ann John
title_short Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017
title_full Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017
title_fullStr Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017
title_full_unstemmed Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017
title_sort Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981–2017
author_id_str_mv ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Ann John
author2 Nadine Dougall
Jan Savinc
Margaret Maxwell
Thanos Karatzias
Rory C. O'Connor
Brian Williams
Ann John
Helen Cheyne
Claire Fyvie
Jonathan I. Bisson
Carina Hibberd
Susan Abbott-Smith
Liz Nolan
Jennifer Murray
format Journal article
container_title BJPsych Open
container_volume 10
container_issue 4
publishDate 2024
institution Swansea University
issn 2056-4724
doi_str_mv 10.1192/bjo.2024.69
publisher Royal College of Psychiatrists
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description BackgroundChildhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.AimTo determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.MethodPopulation-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).ResultsRecords were extracted for 2477 ‘cases’ and 24 777 ‘controls’; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10–17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4–3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7–7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aORmale = 8.17 (95% CI, 5.02–13.29), aORfemale = 15.08 (95% CI, 8.07–28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aORmale = 1.90 (95% CI, 1.64–2.21), aORfemale = 2.65 (95% CI, 1.94–3.62), and each mental health admission by aORmale = 2.06 (95% CI, 1.81–2.34), aORfemale = 1.78 (95% CI, 1.50–2.10).ConclusionsOur lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential ‘at-risk’ adolescents to prevent future suicidal acts, especially those in general hospitals.
published_date 2024-07-01T12:58:34Z
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