Resident University of Hawaii honolulu, Hawaii, United States
Background: Suicide remains a leading cause of death among U.S. children and adolescents, ranking second for ages 10-14 and third for ages 15-19. Recent national data show a steep rise among children aged 8-12 years, with suicide death rates increasing by approximately 8.2% per year from 2008 to 2022. The relationship between specific medical conditions and suicide attempt (SA) hospitalizations in the pediatric population remains poorly defined. Objective: Characterize the national burden, demographics, and associated psychiatric and medical conditions of pediatric SA hospitalizations in 2022. Explore whether protective features of chronic-illness care are transferable to broader pediatric suicide prevention efforts. Design/Methods: Retrospective, survey‑weighted analysis of the 2022 Kids’ Inpatient Database. SA admissions were identified using ICD self‑harm codes; all other pediatric discharges served as comparators. Exposures were psychiatric and chronic medical conditions. Survey‑weighted logistic regression estimated adjusted odds ratios (aORs) controlling for age, sex, race, primary payer, ZIP‑code income quartile, hospital region, and bedsize. Results: Among 3,009,812 pediatric discharges, an estimated 17,229 involved a SA. Attempt admissions were older (mean 15.9 years) and predominantly female (71%). In adjusted analyses, psychiatric disorders showed significant independent associations with SA; depression (aOR 13.7, 95% CI 12.1–15.4) and bipolar disorder (8.0, 7.0–9.1) were the most significant. In contrast, several chronic medical conditions were inversely associated: type 1 diabetes (0.29, 0.23–0.37), epilepsy (0.58, 0.50–0.68), chronic pain 0.60 (0.49–0.72), migraine 0.66 (0.56–0.79), congenital heart disease (0.34, 0.24–0.50), and sickle-cell disease (0.16, 0.10–0.26) (all p≤0.05), and HIV 0.35 (0.13–0.96) (p=0.042).
Conclusion(s): The demographic and psychiatric profiles observed reinforce existing evidence on risk patterns in pediatric suicide and highlight the consistency of these associations nationwide. Strikingly, chronic medical conditions showed an inverse association with SA hospitalizations. This association could possibly be explained by the frequent medical visits to healthcare professionals, consistent monitoring and surveillance, and a high level of familial support and attention to children with medical conditions. Thus, these elements likely play a protective role in building a support system that can possibly be transferable to broader pediatric populations for SA prevention.
