Rybczynski Suzanne, Gornik Allison, Schindel Benjamin Joffe, Ngur Mwuese, Matte-Ramsdell Teresa, Lopez-Arvizu Carmen, Lipkin Paul H, Zabel T Andrew
Kennedy Krieger Institute (S Rybczynski, A Gornik, BJ Schindel, M Ngur, T Matte-Ramsdell, C Lopez-Arvizu, PH Lipkin, and TA Zabel), Baltimore, Md; Department of Pediatrics (S Rybczynski and PH Lipkin), Johns Hopkins University School of Medicine, Baltimore, Md; East Tennessee Children's Hospital (S Rybczynski), Knoxville, Tenn; Department of Pediatrics (S Rybczynski), University of Tennessee Health Science Center, College of Medicine, Knoxville, Tenn.
Kennedy Krieger Institute (S Rybczynski, A Gornik, BJ Schindel, M Ngur, T Matte-Ramsdell, C Lopez-Arvizu, PH Lipkin, and TA Zabel), Baltimore, Md; Department of Psychiatry and Behavioral Sciences (A Gornik, C Lopez-Arvizu, and TA Zabel), Johns Hopkins University School of Medicine, Baltimore, Md.
Acad Pediatr. 2025 Apr;25(3):102623. doi: 10.1016/j.acap.2024.102623. Epub 2024 Dec 17.
Suicidal thoughts and behaviors in youth have been increasing over the last 30 years, resulting in recommendations to screen for suicide risk. Our aim was to evaluate suicide risk screenings in children during outpatient care at a specialty care facility for those with neurologic, developmental, and behavioral disorders (NDBDs).
This cross-sectional, retrospective study utilized suicide screening data from the Ask Suicide-Screening Questions tool administered to children attending initial outpatient visits at medical, behavioral health, or autism specialty clinics serving individuals with NDBDs. Primary outcomes included whether screening occurred or was declined, and if it yielded elevated risk for suicide. Predictive factors were examined.
In total, 15,462 children aged 8 to 17 (38.4% female; 47.7% White, 26.0% Black; 21.0% Medicaid) were offered screening as part of routine care. Overall, 10,970 children underwent screening; 4492 (29.1%) declined. The probability of declined screenings was greater if children were younger, male, attended a medical clinic appointment and were offered the screening prior to the COVID-19 pandemic. The overall rate of positive screening was 10.3%. Children as young as age 8 screened positive in all settings. Positive screening rates in medical, behavioral health, and autism specialty clinics were 7.9%, 12.2%, and 12.7%, respectively. Screenings were more likely to be positive for children who were older, female, self-reported rather than caregiver-reported, and occurring within a behavioral health or autism specialty clinic.
Suicide risk was identified in children across all pediatric programs, indicating strong support for universal suicide screening of children and youth in pediatric settings.
在过去30年中，青少年的自杀念头和行为一直在增加，因此有人建议对自杀风险进行筛查。我们的目的是评估在一家为患有神经、发育和行为障碍（NDBDs）的患者提供专科护理的机构中，儿童在门诊护理期间的自杀风险筛查情况。
这项横断面回顾性研究利用了向在为患有NDBDs的患者提供服务的医疗、行为健康或自闭症专科诊所进行初次门诊就诊的儿童所使用的“询问自杀筛查问题”工具的自杀筛查数据。主要结果包括是否进行了筛查或筛查被拒绝，以及筛查是否显示出自杀风险升高。对预测因素进行了检查。
共有15462名8至17岁的儿童（38.4%为女性；47.7%为白人，26.0%为黑人；21.0%参加医疗补助计划）作为常规护理的一部分接受了筛查。总体而言，10970名儿童接受了筛查；4492名（29.1%）拒绝了筛查。如果儿童年龄较小、为男性、参加医疗诊所预约且在2019冠状病毒病大流行之前接受筛查，那么拒绝筛查的可能性更大。总体阳性筛查率为10.3%。8岁的儿童在所有环境中均有阳性筛查结果。医疗、行为健康和自闭症专科诊所的阳性筛查率分别为7.9%、12.2%和12.7%。年龄较大、女性、自我报告而非由照顾者报告且在行为健康或自闭症专科诊所进行的筛查，更有可能呈阳性。
在所有儿科项目的儿童中都发现了自杀风险，这表明强烈支持在儿科环境中对儿童和青少年进行普遍的自杀筛查。
