背景:证据表明患有慢性身体疾病(CPI;例如,哮喘,糖尿病,和癫痫)是自杀的独立危险因素(即,自杀意念或企图)在年轻人中。关于CPI和自杀联系的机制知之甚少。一些证据表明精神疾病(例如,抑郁和焦虑)或神经发育障碍(例如,注意力缺陷/多动障碍)介导或缓和CPI-自杀关联。知识库中缺少有关同时发生的CPI与年轻人自杀的精神疾病或神经发育障碍(MIND)之间的关联的信息。
目的:本研究使用来自2019年加拿大儿童和青少年健康调查(CHSCY)的流行病学数据来研究CPI,心灵,和年轻时的自杀。我们将估计患病率,确定预测因子,并调查患有CPI-MIND合并症的青年与其他发病率组的社会心理和服务使用结果(即,健康,仅限CPI,只有心灵)。
方法:由加拿大统计局执行,CHSCY收集了47,850名儿童(1-17岁)及其主要照顾父母的数据.青年消费物价指数的衡量标准,心灵,家庭环境,和社会人口统计数据可以使用青年和家长线人。有关精神病服务使用的信息可通过家长报告以及与国家门诊护理报告系统和出院摘要数据库中发现的国家行政健康数据的链接获得,允许对医院精神卫生服务进行调查(例如,急诊部门的访问,住院治疗,和住院时间)。关于自杀的问题仅限于15-17岁的年轻人(n=6950),形成我们的分析样本。基于加权回归的分析将解释复杂的调查设计。
结果:我们的研究始于2023年11月,由美国自杀预防基金会(SRG-0-008-22)资助。对链接的CHSCY微数据文件的访问权限于2024年5月获得。对CHSCY数据的初步检查显示,大约20%(1390/6950)的年轻人有CPI,7%(490/6950)有想法,7%(490/6950)在过去一年中认真考虑过自杀,3%(210/6950)在其一生中曾尝试过自杀。
结论:研究结果将提供对患有CPI-MIND合并症的年轻人的自杀倾向的估计,这将为干预计划提供信息,以防止这一弱势群体的生命损失。自杀性的建模关联将促进对多个层面因素的相对和联合影响的理解-针对预防工作和服务所需的信息。了解精神病服务的使用方式对于了解服务的获取和障碍至关重要。这将通知是否使用匹配需要,确定机会,向政策制定者提供上游资源的建议,以防止自杀。重要的是,调查结果将提供关于青少年CPI-MIND合并症与自杀倾向之间联系的可靠基线信息,未来的研究可用于解决与COVID-19大流行的影响以及相关对策在这一脆弱青年人群中的相关问题。
■DERR1-10.2196/57103。
BACKGROUND: Evidence suggests that having a chronic physical illness (CPI; eg, asthma, diabetes, and epilepsy) is an independent risk factor for
suicidality (ie, suicidal ideation or attempts) among youth. Less is known about the mechanisms linking CPI and
suicidality. Some evidence suggests that mental illness (eg, depression and anxiety) or neurodevelopmental disorder (eg, attention-deficit/hyperactivity disorder) mediates or moderates the CPI-suicidality association. Missing from the knowledge base is information on the association between having co-occurring CPI and mental illness or neurodevelopmental disorder (MIND) on youth suicidality.
OBJECTIVE: This study uses epidemiological data from the 2019 Canadian Health Survey of Children and Youth (CHSCY) to study the intersection of CPI, MIND, and suicidality in youth. We will estimate prevalence, identify predictors, and investigate psychosocial and service use outcomes for youth with CPI-MIND comorbidity versus other morbidity groups (ie, healthy, CPI only, and MIND only).
METHODS: Conducted by Statistics Canada, the CHSCY collected data from 47,850 children (aged 1-17 years) and their primary caregiving parent. Measures of youth CPI, MIND, family environment, and sociodemographics are available using youth and parent informants. Information on psychiatric services use is available via parent report and linkage to national administrative health data found in the National Ambulatory Care Reporting System and the Discharge Abstract Database, which allow the investigation of hospital-based mental health services (eg, emergency department visits, hospitalizations, and length of stay in hospital). Questions about
suicidality were restricted to youths aged 15-17 years (n=6950), which form our analytic sample. Weighted regression-based analyses will account for the complex survey design.
RESULTS: Our study began in November 2023, funded by the American Foundation for Suicide Prevention (SRG-0-008-22). Access to the linked CHSCY microdata file was granted in May 2024. Initial examination of CHSCY data shows that approximately 20% (1390/6950) of youth have CPI, 7% (490/6950) have MIND, 7% (490/6950) seriously considered suicide in the past year, and 3% (210/6950) had attempted suicide anytime during their life.
CONCLUSIONS: Findings will provide estimates of
suicidality among youth with CPI-MIND comorbidity, which will inform intervention planning to prevent loss of life in this vulnerable population. Modeling correlates of
suicidality will advance understanding of the relative and joint effects of factors at multiple levels-information needed to target prevention efforts and services. Understanding patterns of psychiatric service use is vital to understanding access and barriers to services. This will inform whether use matches need, identifying opportunities to advise policy makers about upstream resources to prevent suicidality. Importantly, findings will provide robust baseline of information on the link between CPI-MIND comorbidity and suicidality in youth, which can be used by future studies to address questions related to the impact of the COVID-19 pandemic and associated countermeasures in this vulnerable population of youth.
UNASSIGNED: DERR1-10.2196/57103.