Heslin Kathleen P, Montero Michelle, Faraone Stephen V, Zhang-James Yanli
SUNY Upstate Medical University, Department of Psychiatry, 750 E. Adams St, Syracuse, NY 13210.
Norton College of Medicine at SUNY Upstate Medical University, Department of Psychiatry and Behavioral Sciences, 505 Irving Ave, Syracuse, NY 13210 USA.
medRxiv. 2024 Dec 3:2024.12.02.24318197. doi: 10.1101/2024.12.02.24318197.
Suicide and self-harm remain critical concerns in youth. This study compares patients with and without suicidality or self-harm (SOSH), suicidality (SI/SA), and COVID-19 to investigate 53 pre-existing risk factors associated with suicidality in patients with and without COVID-19.
A retrospective case-control study was conducted using TriNetX data from 111,631,250 patients across 78 healthcare networks. This study included patients aged 0-21 with any healthcare visit between January 20, 2020, and May 11, 2023.
Comparison groups shared many risk factors, with specific differences. Children with SOSH and COVID-19 had higher odds of support group problems, personality disorder, thyroid disorders, and insomnia; children with SOSH without COVID-19 had higher odds of upbringing problems, anxiety and nonpsychotic disorders, sleep disorders, and autism. Adolescents with SOSH and COVID-19 had higher odds of parent-child conflict; adolescents with SOSH without COVID-19 had higher odds of education and literacy problems. Children with SI/SA and COVID-19 had higher odds of support group problems, personality disorders, and asthma; children with SI/SA without COVID-19 had higher odds of autism. Adolescents with SI/SA and COVID-19 had higher odds of asthma. The effect size of COVID-19 was not significant. SOSH was associated with increased odds of prior SARS-CoV-2 infection in children (OR 2.42) and adolescents (OR 1.88).
This study confirms known SOSH risk factors and demonstrates their association with suicidality. We observed a significant association between SOSH and preceding SARS-CoV-2 infection. This underscores the need to focus on suicide risk in youth affected by COVID-19.
自杀和自我伤害仍是青少年中的关键问题。本研究比较了有和没有自杀倾向或自我伤害行为（SOSH）、有自杀倾向（SI/SA）以及感染新冠病毒的患者，以调查53种与有和没有新冠病毒的患者自杀倾向相关的既往风险因素。
利用来自78个医疗网络的111,631,250名患者的TriNetX数据进行了一项回顾性病例对照研究。本研究纳入了2020年1月20日至2023年5月11日期间有任何医疗就诊记录的0至21岁患者。
比较组有许多共同的风险因素，但也存在特定差异。患有SOSH且感染新冠病毒的儿童出现支持小组问题、人格障碍、甲状腺疾病和失眠的几率更高；患有SOSH但未感染新冠病毒的儿童出现养育问题、焦虑和非精神病性障碍、睡眠障碍和自闭症的几率更高。患有SOSH且感染新冠病毒的青少年出现亲子冲突的几率更高；患有SOSH但未感染新冠病毒的青少年出现教育和读写问题的几率更高。患有SI/SA且感染新冠病毒的儿童出现支持小组问题、人格障碍和哮喘的几率更高；患有SI/SA但未感染新冠病毒的儿童出现自闭症的几率更高。患有SI/SA且感染新冠病毒的青少年出现哮喘的几率更高。新冠病毒的影响大小不显著。SOSH与儿童（OR 2.42）和青少年（OR 1.88）先前感染SARS-CoV-2的几率增加有关。
本研究证实了已知的SOSH风险因素，并证明了它们与自杀倾向的关联。我们观察到SOSH与先前感染SARS-CoV-2之间存在显著关联。这凸显了关注受新冠病毒影响的青少年自杀风险的必要性。
