From the Department of Pediatrics, Sections of Emergency Medicine.
Pediatr Emerg Care. 2024 Sep 1;40(9):e227-e232. doi: 10.1097/PEC.0000000000003206. Epub 2024 Aug 23.
The aim of this study was to examine the association between prolonged time in the COVID-19 pandemic and rates of positive routine suicide screens among youth accessing healthcare in the pediatric emergency department.
Participants were English- and Spanish-speaking youth aged 10-18 years presenting without an acute mental/behavioral health concern to the emergency department or urgent care of a large hospital system, serving a 7-state region, who completed routine screening for suicide risk. Visits between March 1, 2019 and December 31, 2021 were included. We conducted a quasi-experimental interrupted time series analysis and categorized visits into the prepandemic year, COVID-19 year 1 (Y1), and COVID-19 year 2 (Y2). The primary outcome measure was rate of positive suicide screen.
A total of 33,504 children completed routine suicide screening; 2689 children had a positive screen. The overall rate of positive suicide screens increased throughout the pandemic compared with baseline (7.5% prepandemic, 8.4% Y1, 9.3% Y2; P < 0.01). Rates of positive suicide screens in Y1 increased 0.04% per week and surpassed prepandemic rates, then decreased 0.1% per week throughout Y2 ( P < 0.01), during a time when social distancing mitigation efforts decreased.
Cumulative time in the COVID-19 pandemic was associated with increased positive suicide screens in children. School reopening and normalization of social routines preceded an observed negative trend in rates of positive suicide screens in Y2 of the pandemic. This study demonstrates fluctuating trends in suicide screen positivity, potentially influenced by social distancing and public health measures. Our study may support that maintaining social connectedness and access to school-based or community resources may be a protective factor for youth suicide risk during a pandemic or other natural occurrence.
本研究旨在探讨在大医院系统的儿科急诊就诊的青少年中，因新冠疫情而长时间居家与常规自杀筛查阳性率之间的关联。
参与者为 10-18 岁的英语和西班牙语使用者，他们因非急性精神/行为健康问题到急诊或急症护理就诊，服务于一个覆盖 7 个州的地区。这些患者均完成了常规自杀风险筛查。2019 年 3 月 1 日至 2021 年 12 月 31 日期间的就诊记录均被纳入研究。我们进行了准实验性中断时间序列分析，并将就诊记录分为大流行前一年、新冠疫情第一年（Y1）和第二年（Y2）。主要结局指标是阳性自杀筛查率。
共有 33504 名儿童完成了常规自杀筛查，其中 2689 名儿童的筛查结果呈阳性。与基线相比，整个疫情期间阳性自杀筛查率均呈上升趋势（大流行前为 7.5%，Y1 为 8.4%，Y2 为 9.3%；P < 0.01）。Y1 期间阳性自杀筛查率每周增加 0.04%，超过大流行前的水平，随后在 Y2 期间每周下降 0.1%（P < 0.01），这一期间社交距离缓解措施减少。
新冠疫情期间累计时间与儿童阳性自杀筛查率的增加有关。学校重新开放和社会常规的正常化先于 Y2 期间阳性自杀筛查率的观察到的下降趋势。本研究表明自杀筛查阳性率存在波动趋势，这可能受到社交距离和公共卫生措施的影响。我们的研究结果可能表明，在大流行或其他自然事件期间，保持社交联系和获得学校或社区资源可能是青少年自杀风险的保护因素。
