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Eur Child Adolesc Psychiatry (2013) 22:1322 DOI 10.1007/s00787-012-0311-8
ORIGINAL CONTRIBUTION
Adverse childhood experiences and suicidal behavior of adolescent psychiatric inpatients
Reetta Isohookana Kaisa Riala Helina Hakko
Pirkko Rasanen
Received: 15 February 2012 / Accepted: 12 July 2012 / Published online: 29 July 2012 Springer-Verlag 2012
Abstract The present study examines the association of adverse childhood experiences (ACEs) to suicidal behavior and mortality in 508 Finnish adolescents (aged 1217 years) who required acute psychiatric hospitalization between April 2001 and March 2006. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) and the European Addiction Severity Index (EuropASI) were used to obtain information about ACEs, adolescents suicidal behavior and psychiatric diagnoses. The cases of death were obtained from Statistics Finland. The results of our study indicated that, among girls, exposure to sexual abuse statistically signicantly increased the risk of non-suicidal self-injury (NSSI) (OR, 1.8; 95 % CI, 1.03.2) and suicide attempts (OR, 2.3; 95 % CI, 1.04.5). The cumulative number of ACEs was also associated with an increased risk of NSSI (OR, 1.2; 95 % CI, 1.0- 1.4) and suicide attempts (OR, 1.2; 95 % CI, 1.01.4) in girls. Among all deceased adolescents, ACEs were most notable among those who had died due to accidents and injuries. Gender differences in the types of ACEs were noted and discussed.
Keywords Adolescent Adverse childhood experiences
Mortality Non-suicidal self-injury (NSSI) Sexual abuse
Suicide attempt
Introduction
Adverse childhood experiences (ACEs) have been associated with mental health problems in children and adults [15]. Emotional, sexual and physical abuse as well as household dysfunctions such as parental alcohol or drug abuse, mental illness and divorce, have frequently been termed as ACEs [13, 6]. Several studies have investigated retrospectively the inuence of various groups of ACEs as risk factors of psychiatric disorders or suicidal behavior occurring later in adulthood [3, 5, 7]. For example, a study from New Zealand indicated that women who had been exposed to sexual abuse before the age of 16 years had an 18-fold risk of having attempted suicide at some time in their lives compared to those who had not experienced sexual abuse. In addition, exposure to physical abuse in childhood increased the risk of suicide attempt more than fourfold [7].
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