Celedonia Karen L, Karukivi Max, Valenti Michael W, Geldsetzer Pascal, Wilson Michael Lowery
Turku Brain Injury Centre, Injury Epidemiology and Prevention (IEP) Research Group, Turku University Hospital, University of Turku, Turku, Finland.
Social Research and Innovation Center, Pressley Ridge, Pittsburgh, PA, USA.
Community Ment Health J. 2025 Jan;61(1):130-137. doi: 10.1007/s10597-024-01334-y. Epub 2024 Aug 7.
Adolescent suicide is a major public health concern, particularly among adolescents who have endured Adverse Childhood Experiences (ACEs). Adolescents who have been exposed to multiple ACEs are as much as three times more likely to present with suicidality compared to the general adolescent population. Adolescents who have been exposed to multiple ACEs are also more likely to receive behavioral and mental health services in the community. It is therefore important to understand patterns of suicidality among this sub-population of adolescents in order to provide the best clinical care. The present study examined the temporal patterns of suicidality among adolescents who have been exposed to multiple ACEs and are receiving behavioral and mental health services in the community. Using Electronic Health Record (EHR) data from a community-based behavioral and mental health care organization, an exploratory survival analysis was conducted on time to suicidal thoughts and behaviors (STBs) after suicidality risk screen at intake. Average time from suicidality risk screen at intake to STB was 185 days (6.2 months). Youth who screened negative for suicidality risk at intake had a longer survival time than youth who screened positive for suicidality risk, and the survival distributions between the two groups was significant. Predictors of STBs were also examined, with gender being a significant predictor of an STB occurring during the follow-up period. These findings may be used to guide suicidality screening and clinical practice at community-based behavioral and mental health care organizations serving adolescents who have been exposed to multiple ACEs.
青少年自杀是一个重大的公共卫生问题，尤其是在那些经历过童年不良经历（ACEs）的青少年中。与普通青少年群体相比，遭受多种ACEs的青少年出现自杀倾向的可能性高达三倍。遭受多种ACEs的青少年也更有可能在社区接受行为和心理健康服务。因此，了解这一青少年亚群体的自杀倾向模式对于提供最佳临床护理至关重要。本研究调查了遭受多种ACEs且在社区接受行为和心理健康服务的青少年自杀倾向的时间模式。利用一个基于社区的行为和心理健康护理组织的电子健康记录（EHR）数据，对入院时自杀风险筛查后出现自杀念头和行为（STBs）的时间进行了探索性生存分析。从入院时自杀风险筛查到出现STB的平均时间为185天（6.2个月）。入院时自杀风险筛查呈阴性的青少年比自杀风险筛查呈阳性的青少年生存时间更长，两组之间的生存分布具有显著性。还对STBs的预测因素进行了检查，性别是随访期间发生STB的一个显著预测因素。这些发现可用于指导为遭受多种ACEs的青少年提供服务的社区行为和心理健康护理组织的自杀倾向筛查和临床实践。
