Incidence, risk and resilience for suicide attempts among children and youth born in 1983-1989 and living in Denmark in 2007 By MSc. Erik Christiansen Klinik for selvmordstruede OUH, Odense, Denmark MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Incidence The Danish national incidence rate for suicide attempts for children and youth is unknown and only a few estimates have been made Estimates made by Centre for suicide research, Denmark. Estimates are based on admissions to somatic and psychiatric hospital in the county of Fyen MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Incidence Estimate is based on all admissions to somatic and psychiatric hospital doing 1990-2007. Only admissions registered as suicide attempts were used. MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Estimates of risk factors were based on the 3,465 début suicide attempters. 21 % boys and 79 % girls. Age distribution from 10 to 24 years. MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk 20 controls were matched to every case by age and gender Risk 20 controls were matched to every case by age and gender. 72,765 individuals were analysed A wide range of risk factors were estimated. Socio-demographic, hospitalization to mental and somatic department, level of education, occupation, income, ect. for the children and the parents. Many of the well-known risk factors (characteristics) are also significant risk factors in this study Focus on two risk factors: Children's hospitalization to psychiatric department and loss of parent/parents MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Hospitalization to psychiatric department MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Hospitalization to psychiatric department It is a significant risk factor for suicide attempt to be hospitalized to psychiatric department. They are hospitalized because they are: - in high risk for suicide - suffer from mental illness - perhaps suffering from mental illness - abuse of substances - affects Hospitalization is an prediction for high suicide attempts risk MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Admitted and discharged from psychiatric department MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Admitted and discharged from psychiatric department MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Hospitalization to psychiatric department The risk is very high within the first days/weeks after hospitalized or discharged from psychiatric department Conclusion A need for co-operation between the social and the health sector MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Numbers of hospitalization to psychiatric department MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Numbers of hospitalization to psychiatric department The risk for suicide attempts is higher for children and young ones who have had many admissions to psychiatric department MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Diagnoses MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Diagnoses Individuals with substance abuse, disorder of adult personality and mood disorder are at highest risk. MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Fathers level of income as a moderator on risk MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Fathers level of income as a moderator on risk Individuals who have been hospitalized and the level of the fathers income are at a medium or high level are in lower risk compared to individuals where the fathers income is low. The same results were found when analyzing fathers level of education. The higher level of education the lower risk. Medium or high income are a moderator on risk but do not eliminate the entity risk. Conclusion Children and youth from families with medium or high income are less in risk for suicide attempts, despite high risk MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk It is a significant risk factor to loss ones mother MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Loss of mother The risk is significant after 3 months Risk Loss of mother The risk is significant after 3 months. It has a peak in the period 3-6 months after mothers death MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Loss of mother The cause of death MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Loss of mother Fathers level of income as a moderator on risk MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Loss of mother Fathers level on income is a moderator on risk on suicide attempts after loss of mother Medium and high level of income is eliminating the risk. Same results with fathers level of education as moderator Conclusion Only children and youth from low income/ low level of education families are at risk after loss of mother. MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark

Risk Conclusions Traumatic events like hospitalization on psychiatric department or loss of mother do not affect all children and youth equally Some family characteristics like fathers level of education or income are significant moderators on risk. The characteristics are correlated with the child's suicidal behavior In order to understand the complexity of risk factors more research in protective factors (resilience) is needed Thank you for your attention ! MSc. Erik Christiansen, Klinik for Selvmordstruede, Det børne- og ungdomspsykiatriske hus, OUH, Odense, Denmark