Pediatric ICU Admissions After Adolescent Suicide Attempts During the Pandemic

Nora Bruns¹, Lea Willemsen¹, Andreas Stang², Bernd Kowall², Katharina Holtkamp¹, Oliver Kamp³, Marcel Dudda³, Florian Hey⁴, Florian Hoffmann⁴, Judith Blankenburg⁵, Frank Eifinger⁶, Hans Fuchs⁷, Roland Haase⁸, Jan Baier⁸, Clemens Andrée⁹, Michael Heldmann¹⁰, Vanessa Maldera¹⁰, Jenny Potratz¹¹, Daniel Kurz¹², Nadine Mand¹³, Claus Doerfel¹⁴, Tobias Rothoeft¹⁵, Michel Schultz¹⁵, Manuel Ohlert¹⁶, Katrin Silkenbäumer¹⁷, Thomas Boesing¹⁷, Fithri Indraswari¹⁸, Frank Niemann¹⁹, Peter Jahn²⁰, Michael Merker²¹, Nicole Braun²², Francisco Brevis Nunez²³, Matthias Engler²⁴, Konrad Heimann²⁵, Milian Brasche²⁵, Gerhard Wolf²⁶, Holger Freymann²⁷, Martin Dercks²⁸, Marc Hoppenz²⁹, Ursula Felderhoff-Müser¹, Christian Dohna-Schwake¹

Affiliations

¹ Department of Pediatrics I, Pediatric Intensive Care Medicine.
² Institute of Medical Informatics, Biometry and Epidemiology.
³ Department of Trauma, Hand and Reconstructive Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany.
⁴ Pediatric Clinic and Pediatric Polyclinic at the Dr. von Haunerschen Children's Hospital, Interdisciplinary pediatric ICU - Pediatric Emergency Medicine, LMU Munich, Munich, Germany.
⁵ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Dresden, University of Technology Dresden, Dresden, Germany.
⁶ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
⁷ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Freiburg, University of Freiburg, Freiburg, Germany.
⁸ Department of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, University Hospital Halle, University of Halle, Halle, Germany.
⁹ Department of Pediatrics, Pediatric Intensive Care Medicine, Helios Hospital Krefeld, Krefeld, Germany.
¹⁰ Department of Pediatrics, Pediatric Intensive Care Medicine, Helios University Hospital Wuppertal, Wuppertal, Germany.
¹¹ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital, Münster, Münster, Germany.
¹² Department of Pediatrics 3, Pediatric Cardiology, Pediatric Intensive Care Medicine, Olgahospital Stuttgart, Stuttgart, Germany.
¹³ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Marburg, Philipps University of Marburg, Marburg, Germany.
¹⁴ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Jena, University of Jena, Jena, Germany.
¹⁵ Department of Pediatrics, Pediatric Intensive Care Medicine, Catholic Hospital Bochum, Ruhr-University of Bochum, Bochum, Germany.
¹⁶ Department of Pediatrics, Pediatric Intensive Care Medicine, Community Hospital Koblenz, Koblenz, Germany.
¹⁷ Department of Pediatrics, Pediatric Intensive Care Medicine, Protestant Hospital Bethel, University of Bielefeld, Bielefeld, Germany.
¹⁸ Department of Pediatrics, Pediatric Intensive Care Medicine, Hospital Fulda, Fulda, Germany.
¹⁹ Department of Pediatrics, Pediatric Intensive Care Medicine, Bergmannsheil and Pediatric Hospital Buer, Gelsenkirchen, Germany.
²⁰ Department of Pediatrics, Pediatric Intensive Care Medicine, Hospital Leverkusen gGmbH, Leverkusen, Germany.
²¹ Department for Children and Adolescents, Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
²² Clinic of Pediatric Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany.
²³ Department of Pediatrics, Pediatric Intensive Care Medicine, Sana Hospitals Duisburg, Duisburg, Germany.
²⁴ Department of Pediatrics, Pediatric Intensive Care Medicine, Sana Hospital Offenbach, Offenbach, Germany.
²⁵ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.
²⁶ Department of Pediatrics, Pediatric Intensive Care Medicine, Hospital of Traunstein, Southeast Bavaria Hospitals, Traunstein, Germany.
²⁷ Department of Pediatrics, Pediatric Intensive Care Medicine, Florence Nightingale Hospital, Düsseldorf, Germany.
²⁸ Department of Pediatrics, Pediatric Intensive Care Medicine, Clemenshospital Münster, Münster, Germany.
²⁹ Department of Pediatrics, Pediatric Intensive Care Medicine, Cologne Hospitals, Children's Hospital Amsterdamer Str., Cologne, Germany.

PMID: 35534988
DOI: 10.1542/peds.2021-055973

Multicenter Study

Pediatric ICU Admissions After Adolescent Suicide Attempts During the Pandemic

Nora Bruns et al. Pediatrics. 2022.

. 2022 Aug 1;150(2):e2021055973.

doi: 10.1542/peds.2021-055973.

Authors

Affiliations

¹ Department of Pediatrics I, Pediatric Intensive Care Medicine.
² Institute of Medical Informatics, Biometry and Epidemiology.
³ Department of Trauma, Hand and Reconstructive Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany.
⁴ Pediatric Clinic and Pediatric Polyclinic at the Dr. von Haunerschen Children's Hospital, Interdisciplinary pediatric ICU - Pediatric Emergency Medicine, LMU Munich, Munich, Germany.
⁵ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Dresden, University of Technology Dresden, Dresden, Germany.
⁶ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
⁷ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Freiburg, University of Freiburg, Freiburg, Germany.
⁸ Department of Pediatrics, Neonatology and Pediatric Intensive Care Medicine, University Hospital Halle, University of Halle, Halle, Germany.
⁹ Department of Pediatrics, Pediatric Intensive Care Medicine, Helios Hospital Krefeld, Krefeld, Germany.
¹⁰ Department of Pediatrics, Pediatric Intensive Care Medicine, Helios University Hospital Wuppertal, Wuppertal, Germany.
¹¹ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital, Münster, Münster, Germany.
¹² Department of Pediatrics 3, Pediatric Cardiology, Pediatric Intensive Care Medicine, Olgahospital Stuttgart, Stuttgart, Germany.
¹³ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Marburg, Philipps University of Marburg, Marburg, Germany.
¹⁴ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Jena, University of Jena, Jena, Germany.
¹⁵ Department of Pediatrics, Pediatric Intensive Care Medicine, Catholic Hospital Bochum, Ruhr-University of Bochum, Bochum, Germany.
¹⁶ Department of Pediatrics, Pediatric Intensive Care Medicine, Community Hospital Koblenz, Koblenz, Germany.
¹⁷ Department of Pediatrics, Pediatric Intensive Care Medicine, Protestant Hospital Bethel, University of Bielefeld, Bielefeld, Germany.
¹⁸ Department of Pediatrics, Pediatric Intensive Care Medicine, Hospital Fulda, Fulda, Germany.
¹⁹ Department of Pediatrics, Pediatric Intensive Care Medicine, Bergmannsheil and Pediatric Hospital Buer, Gelsenkirchen, Germany.
²⁰ Department of Pediatrics, Pediatric Intensive Care Medicine, Hospital Leverkusen gGmbH, Leverkusen, Germany.
²¹ Department for Children and Adolescents, Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
²² Clinic of Pediatric Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany.
²³ Department of Pediatrics, Pediatric Intensive Care Medicine, Sana Hospitals Duisburg, Duisburg, Germany.
²⁴ Department of Pediatrics, Pediatric Intensive Care Medicine, Sana Hospital Offenbach, Offenbach, Germany.
²⁵ Department of Pediatrics, Pediatric Intensive Care Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.
²⁶ Department of Pediatrics, Pediatric Intensive Care Medicine, Hospital of Traunstein, Southeast Bavaria Hospitals, Traunstein, Germany.
²⁷ Department of Pediatrics, Pediatric Intensive Care Medicine, Florence Nightingale Hospital, Düsseldorf, Germany.
²⁸ Department of Pediatrics, Pediatric Intensive Care Medicine, Clemenshospital Münster, Münster, Germany.
²⁹ Department of Pediatrics, Pediatric Intensive Care Medicine, Cologne Hospitals, Children's Hospital Amsterdamer Str., Cologne, Germany.

PMID: 35534988
DOI: 10.1542/peds.2021-055973

Abstract

Background and objectives: The worldwide severe acute respiratory syndrome coronavirus 2 pandemic challenges adolescents' mental health. In this study, we aim to compare the number of pediatric ICU (PICU) admissions after suicide attempts during the first German lockdown and one year later during a second, prolonged lockdown with prepandemic years.

Methods: A retrospective multicenter study was conducted among 27 German PICUs. Cases <18 years admitted to the PICU because of accidents or injuries between March 16 and May 31 of 2017 to 2021 were identified based on International Classification of Diseases, 10th Revision codes (German modification) and patient data entered into a database. This study is a subset analysis on suicide attempts in adolescents aged 12 to 17.9 years. The Federal Statistics Office was queried for data on fatal suicides, which were available only for 2020 in adolescents aged 10 to 17.9 years.

Results: Total admissions and suicide attempts declined during the first lockdown in 2020 (standardized morbidity ratio 0.74 (95% confidence interval; 0.58-0.92) and 0.69 (0.43-1.04), respectively) and increased in 2021 (standardized morbidity ratio 2.14 [1.86-2.45] and 2.84 [2.29-3.49], respectively). Fatal suicide rates remained stable between 2017 to 2019 and 2020 (1.57 vs 1.48 per 100 000 adolescent years) with monthly numbers showing no clear trend during the course of 2020.

Conclusions: This study shows a strong increase in serious suicide attempts among adolescents during the course of the pandemic in Germany. More research is needed to understand the relation between pandemic prevention measures and suicidal ideation to help implement mental health support for adolescents.

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Pediatric ICU Admissions After Adolescent Suicide Attempts During the Pandemic

Affiliations

Pediatric ICU Admissions After Adolescent Suicide Attempts During the Pandemic

Authors

Affiliations

Abstract

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LinkOut - more resources

Full Text Sources

Medical