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Child maltreatment and repeat presentations to the emergency department for suicide-related behaviors

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dc.contributor.author Rhodes, A. E., Boyle, M. H., Bethell, J., Wekerle, C., Tonmyr, L., Goodman, D., ... & Manion, I.
dc.date.accessioned 2014-08-22T15:26:10Z
dc.date.available 2014-08-22T15:26:10Z
dc.date.issued 2013
dc.identifier.citation Rhodes, A. E., Boyle, M. H., Bethell, J., Wekerle, C., Tonmyr, L., Goodman, D., ... & Manion, I. (2013). Child maltreatment and repeat presentations to the emergency department for suicide-related behaviors. Child abuse & neglect, 37(2), 139-149. en_US
dc.identifier.uri http://www.sciencedirect.com/science/article/pii/S0145213412002256
dc.identifier.uri http://hdl.handle.net/11212/1662
dc.description.abstract To identify factors associated with repeat emergency department (ED) presentations for suicide-related behaviors (SRB) – hereafter referred to as repetition – among children/youth to aid secondary prevention initiatives. To compare rates of repetition in children/youth with substantiated maltreatment requiring removal from their parental home with their peers in the general population. Methods A population-based (retrospective) cohort study was established for children/youth with a first ED SRB presentation at risk for repetition in the Province of Ontario, Canada between 1 January 2004 and 31 December 2008. Children/youth legally removed from their parental home because of substantiated maltreatment (n = 179) and their population-based peers (n = 6,305) were individually linked to administrative health care records over time to ascertain social, demographic, and clinical information and subsequent ED presentations for SRB during follow-up. These children/youth were described and their repetition-free probabilities over time compared. To identify factors associated with repetition we fit multivariable, recurrent event survival analysis models stratified by repetition and present unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results Children/youth with substantiated maltreatment (as noted) were two times more likely to have repetition than their peers after adjustments for social, demographic, and clinical factors (conditional on prior ED SRB presentations). A number of these factors were independently associated with repetition. No one factor distinguished between having a first and second repetition nor was more strongly associated with repetition than another. Conclusions The risk of repetition is higher in children with substantiated maltreatment (as noted) than their peers. No one factor stood out as predictive of repetition. Implications for secondary prevention initiatives include a non-selective approach, sensitive to family difficulties and the need to better contextualize repetition and harness data linkages en_US
dc.language.iso en_US en_US
dc.publisher Child Abuse & Neglect en_US
dc.subject self-injury en_US
dc.subject suicide en_US
dc.subject attempted suicide en_US
dc.subject child abuse en_US
dc.subject child welfare en_US
dc.subject emergency medicine en_US
dc.title Child maltreatment and repeat presentations to the emergency department for suicide-related behaviors en_US
dc.type Article en_US


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