ARTICLE Hospitalization for Suicide Ideation or Attempt: 2008 –2015 Gregory Plemmons, MD, a Matthew Hall, PhD, b Stephanie Doupnik, MD, c James Gay, MD, MMHC, a Charlotte Brown, MD, a Whitney Browning, MD, a Robert Casey, MD, a Katherine Freundlich, MD, a David P. Johnson, MD, a Carrie Lind, MD, a Kris Rehm, MD, a Susan Thomas, MD, a Derek Williams, MD, MPH a OBJECTIVES: Suicide ideation (SI) and suicide attempts (SAs) have been reported as increasing among US children over the last decade. We examined trends in emergency and inpatient encounters for SI and SA at US children’ s hospitals from 2008 to 2015. METHODS: We used retrospective analysis of administrative billing data from the Pediatric Health Information System database. RESULTS: There were 115 856 SI and SA encounters during the study period. Annual percentage of all visits for SI and SA almost doubled, increasing from 0.66% in 2008 to 1.82% in 2015 (average annual increase 0.16 percentage points [95% confidence intervals (CIs) 0.15 to 0.17]). Significant increases were noted in all age groups but were higher in adolescents 15 to 17 years old (average annual increase 0.27 percentage points [95% CI 0.23 to 0.30]) and adolescents 12 to 14 years old (average annual increase 0.25 percentage points [95% CI 0.21 to 0.27]). Increases were noted in girls (average annual increase 0.14 percentage points [95% CI 0.13 to 0.15]) and boys (average annual increase 0.10 percentage points [95% CI 0.09 to 0.11]), but were higher for girls. Seasonal variation was also observed, with the lowest percentage of cases occurring during the summer and the highest during spring and fall. CONCLUSIONS: Encounters for SI and SA at US children’ s hospitals increased steadily from 2008 to 2015 and accounted for an increasing percentage of all hospital encounters. Increases were noted across all age groups, with consistent seasonal patterns that persisted over the study period. The growing impact of pediatric mental health disorders has important implications for children’ s hospitals and health care delivery systems. abstract a Monroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee; b Children’s Hospital Association, Lenexa, Kansas; and c Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Drs Plemmons, Hall, Doupnik, Gay, and Williams conceptualized and designed the study and drafted the initial manuscript; Drs Brown, Casey, Browning, Freundlich, Johnson, Lind, Rehm, and Thomas reviewed and assisted with revising the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. DOI: https://doi.org/10.1542/peds.2017-2426 Accepted for publication Mar 9, 2018 Address correspondence to Gregory Plemmons, MD, Monroe Carell Jr. Children’s Hospital at Vanderbilt, 2200 Children’s Way, Nashville, TN 37232-9452. E-mail: gregory.plemmons@vanderbilt. edu PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2018 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. PEDIATRICS Volume 141, number 6, June 2018:e20172426 WHAT’S KNOWN ON THIS SUBJECT: Over the last decade, increases in suicide and depression have been reported in US children in outpatient settings, and the number of children hospitalized with a primary mental health diagnosis also appears to be increasing. WHAT THIS STUDY ADDS: With this study, we provide data on recent trends in hospital visits for suicide attempts and ideation in children seeking care at children’ s hospitals, examining demographic as well as longitudinal and seasonal trends. To cite: Plemmons G, Hall M, Doupnik S, et al. Hospitaliza- tion for Suicide Ideation or Attempt: 2008–2015. Pediatrics. 2018;141(6):e20172426 by guest on June 1, 2020 www.aappublications.org/news Downloaded from