Phenotypic Characterization of Youth Admitted To Acute Psychiatric Inpatient Unit Following Self-Harm Behavior

Abstract

Objective

Deliberate self-harm (DSH) is a major health concern among adolescents, and is often associated with the need for inpatient psychiatric hospitalization. The aim of this study was to identify clinical and demographic characteristics associated with DSH behavior among adolescents admitted to an acute psychiatric inpatient unit.

Method

We retrospectively analyzed data from the electronic medical records of consecutive admittances to a single acute adolescent inpatient unit (n = 703, mean age 15.2). We compared inpatients with DSH to inpatients without DSH and further compared within the DSH group based on the presence of suicidal intent.

Results

Compared to Non-DSH inpatients (n = 497), youths admitted following DSH (n = 206) were more likely to be female (OR = 2.6, 95%CI 1.7–4), currently in depressive exacerbation (OR = 2.4, 95%CI 1.6–3.6), with concurrent suicidal ideation (OR = 3.9, 95%CI 2.5–5.9), and history of alcohol use (OR = 5.6, 95%CI 3.2–9.5). Within DSH youths, no significant clinical differences were identified between those admitted following a suicide attempt (n = 102) compared to non-suicidal-self-injury (n = 104), who were generally younger.

Conclusions

Findings suggest that early detection and intervention of DSH and depressive crisis is warranted, regardless of the self-harm subtype.

HIGHLIGHTS

• Deliberate self-harm is common among adolescent psychiatric inpatients.

• Adolescent inpatients with deliberate self-harm are predominantly females with concurrent depression and suicidal ideation.

• We did not detect significant clinical and demographic differences between self-harmers with or without suicidal intent.

Keywords:

• Adolescence psychiatry
• deliberate self-harm
• non-suicidal self-injury
• suicide

DISCLOSURE STATEMENT

Dr. Barzilay serves on the scientific board and reports stock ownership in “Taliaz Health,” with no conflict of interest relevant to this work. All other authors declare no potential conflict of interest.

AUTHOR NOTES

Maya Schwartz-Lifshitz, Child and Adolescent Psychiatry Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, affiliated to the Sackler Faculty of Medicine of Tel Aviv University, Tel Hashomer, Israel.

David H. Ben-Dor and Yael Bustan, Child and Adolescent Division at Geha Mental Health Center, Petach-Tikva, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.

Gil Zalsman, Child and Adolescent division at Geha Menal Health Center, Petach-Tikva, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel; Molecular Imaging and Neuropathology Division, Psychiatry Department, Columbia University, New York, NY, USA.

Doron Gothelf, Child and Adolescent Psychiatry Unit, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Affiliated to the Sackler Faculty of Medicine of Tel Aviv University, Tel Hashomer, Israel.

Abraham Weizman, Child and Adolescent division at Geha Menal Health Center, Petach-Tikva, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.

Ran Barzilay, Lifespan Brain Institute, Children’s Hospital of Philadelphia and The University of Pennsylvania, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.

Additional information

Funding

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award number [K23MH120437].