Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort Study

Background: Suicidal behavior (SB) and non-suicidal self-injury (NSSI) are significant public health concerns among adolescents. The COVID-19 pandemic may have exacerbated these issues. Methods: This retrospective cohort study analyzed data from 341 adolescents (aged 6–18 years) presenting to a Roma...

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Main Authors: Roxana Șipoș, Tudor Văidean, Elena Predescu
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/1/81
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author Roxana Șipoș
Tudor Văidean
Elena Predescu
author_facet Roxana Șipoș
Tudor Văidean
Elena Predescu
author_sort Roxana Șipoș
collection DOAJ
description Background: Suicidal behavior (SB) and non-suicidal self-injury (NSSI) are significant public health concerns among adolescents. The COVID-19 pandemic may have exacerbated these issues. Methods: This retrospective cohort study analyzed data from 341 adolescents (aged 6–18 years) presenting to a Romanian pediatric psychiatry emergency department during the years 2019 (pre-pandemic) and 2022 (post-pandemic). All participants underwent a thorough psychiatric assessment, and, together with their caregivers, were questioned on a wide range of potentially relevant issues, such as family, social, school, and life history factors. Logistic regression and random forest models were used to identify predictors of SB and NSSI. Results: SB was significantly predicted in regression models based on a prior suicidal ideation (OR = 68.410; <i>p</i> < 0.001), having a parent living abroad (OR = 11.438; <i>p</i> = 0.020), depression (OR = 6.803; <i>p</i> < 0.001), and conflicts with peers (OR = 0.325, <i>p</i> = 0.042), teachers (OR = 0.119, <i>p</i> = 0.024), or both (OR = 0.166, <i>p</i> = 0.012). The random forest model featured a slightly different order of the main predictors and highlighted the importance of additional predictors, such as prior suicide attempts, gender, and past non-suicidal self-injury. NSSI was mainly predicted by a history of self-harm (OR = 52.437; <i>p</i> < 0.001), the number of comorbid psychiatric disorders (OR = 1.709; <i>p</i> = 0.003), and conduct disorder (OR = 0.184; <i>p</i> < 0.001), to which are added, according to random forest models, new predictors, such as borderline personality disorder, suicidal ideation, and school performance. Post-pandemic increases were observed in depression, suicidal ideation, and possible psycho-traumatic negative life event exposure. Conclusions: This study underscores the complex interplay of individual, familial, and societal factors influencing adolescent self-harm. Comprehensive interventions are needed, with early intervention crucial for those with a history of self-harm. Further research using prospective designs is recommended.
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spelling doaj-art-2185d8af6e0e496288293fcec74631fa2025-01-24T13:27:13ZengMDPI AGChildren2227-90672025-01-011218110.3390/children12010081Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort StudyRoxana Șipoș0Tudor Văidean1Elena Predescu2Department of Neuroscience, Psychiatry and Pediatric Psychiatry, “Iuliu Hatieganu” University of Medicine and Pharmacy, 57 Republicii Street, 400489 Cluj-Napoca, RomaniaDepartment of Neuroscience, Psychiatry and Pediatric Psychiatry, “Iuliu Hatieganu” University of Medicine and Pharmacy, 57 Republicii Street, 400489 Cluj-Napoca, RomaniaDepartment of Neuroscience, Psychiatry and Pediatric Psychiatry, “Iuliu Hatieganu” University of Medicine and Pharmacy, 57 Republicii Street, 400489 Cluj-Napoca, RomaniaBackground: Suicidal behavior (SB) and non-suicidal self-injury (NSSI) are significant public health concerns among adolescents. The COVID-19 pandemic may have exacerbated these issues. Methods: This retrospective cohort study analyzed data from 341 adolescents (aged 6–18 years) presenting to a Romanian pediatric psychiatry emergency department during the years 2019 (pre-pandemic) and 2022 (post-pandemic). All participants underwent a thorough psychiatric assessment, and, together with their caregivers, were questioned on a wide range of potentially relevant issues, such as family, social, school, and life history factors. Logistic regression and random forest models were used to identify predictors of SB and NSSI. Results: SB was significantly predicted in regression models based on a prior suicidal ideation (OR = 68.410; <i>p</i> < 0.001), having a parent living abroad (OR = 11.438; <i>p</i> = 0.020), depression (OR = 6.803; <i>p</i> < 0.001), and conflicts with peers (OR = 0.325, <i>p</i> = 0.042), teachers (OR = 0.119, <i>p</i> = 0.024), or both (OR = 0.166, <i>p</i> = 0.012). The random forest model featured a slightly different order of the main predictors and highlighted the importance of additional predictors, such as prior suicide attempts, gender, and past non-suicidal self-injury. NSSI was mainly predicted by a history of self-harm (OR = 52.437; <i>p</i> < 0.001), the number of comorbid psychiatric disorders (OR = 1.709; <i>p</i> = 0.003), and conduct disorder (OR = 0.184; <i>p</i> < 0.001), to which are added, according to random forest models, new predictors, such as borderline personality disorder, suicidal ideation, and school performance. Post-pandemic increases were observed in depression, suicidal ideation, and possible psycho-traumatic negative life event exposure. Conclusions: This study underscores the complex interplay of individual, familial, and societal factors influencing adolescent self-harm. Comprehensive interventions are needed, with early intervention crucial for those with a history of self-harm. Further research using prospective designs is recommended.https://www.mdpi.com/2227-9067/12/1/81adolescentsuicidal behaviornon-suicidal self-injuryrisk factorsCOVID-19 pandemic
spellingShingle Roxana Șipoș
Tudor Văidean
Elena Predescu
Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort Study
Children
adolescent
suicidal behavior
non-suicidal self-injury
risk factors
COVID-19 pandemic
title Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort Study
title_full Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort Study
title_fullStr Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort Study
title_full_unstemmed Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort Study
title_short Risk Factors and Clinical Predictors of Suicidal Behaviors and Non-Suicidal Self-Injury Among Pediatric Psychiatry Emergency Admissions Pre- and Post-Pandemic: A Retrospective Cohort Study
title_sort risk factors and clinical predictors of suicidal behaviors and non suicidal self injury among pediatric psychiatry emergency admissions pre and post pandemic a retrospective cohort study
topic adolescent
suicidal behavior
non-suicidal self-injury
risk factors
COVID-19 pandemic
url https://www.mdpi.com/2227-9067/12/1/81
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