Conflict of interest statement: No conflicts declared.
Young people’s risk of suicide attempts after contact with a psychiatric department – a nested case-control design using Danish register data
Article first published online: 12 MAY 2011
© 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health
Journal of Child Psychology and Psychiatry
Volume 53, Issue 1, pages 16–25, January 2012
How to Cite
Christiansen, E. and Larsen, K. J. (2012), Young people’s risk of suicide attempts after contact with a psychiatric department – a nested case-control design using Danish register data. Journal of Child Psychology and Psychiatry, 53: 16–25. doi: 10.1111/j.1469-7610.2011.02405.x
- Issue published online: 5 DEC 2011
- Article first published online: 12 MAY 2011
- Manuscript accepted 2 February 2011
- Suicide attempts;
- contact with psychiatric department;
- low socio-economic status;
- psychopharmacological drugs
Background: There seems to be an increased risk of children and adolescents committing or attempting suicide after contact with a psychiatric department. Children and adolescents living in families with low socio-economic status (SES) might have an especially increased suicide attempt risk.
Methods: A complete extraction of Danish register data for every individual born in the period 1983–1989 was made. Of these 403,431 individuals, 3,465 had attempted suicide. In order to control for confounder effects from gender, age and calendar-time, a nested case–control study was designed. A total population of 72,765 individuals was used to analyze the risk of suicide attempts after contact with a psychiatric department. The case–control data were analyzed using conditional logistic regression.
Results: This study shows that a child/adolescent’s risk of suicide attempt peaks immediately after discharge from last contact with a psychiatric department. The risk of suicide attempt is highest for children and adolescents suffering from personality disorders, depression and substance use disorders. Children and adolescents with previous contact with a psychiatric department and parental income in the lowest third have a significantly higher risk of suicide attempt. Suicide attempters were more likely to have been given several different diagnoses and several different psychopharmacological drugs prior to their attempted suicide.
Conclusions: The findings in this study highlight the need for psychopathology assessment in every case of attempted suicide. This study also shows that well-known risk factors such as contact with a psychiatric department do not affect all individuals in the same way. Individuals from families with low SES had the highest risk. This suggests that the presence of factors influencing both vulnerability and resiliency, e.g., family level of SES, needs to be included in the assessment.