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Self-injury rates increase among girls, not boys in US

ED visits for self-inflicted injury significantly increased among female youths in the U.S. after 2008, yet remained stable among males, according to recent analysis of CDC data.

“In the United States, youth have the highest burden of nonfatal self-inflicted injury (ie, deliberate physical harm against oneself, inclusive of suicidal and nonsuicidal intent) requiring medical attention,” Melissa C. Mercado, PhD, MSc, MA, of the CDC’s National Center for Injury Prevention and Control, and colleagues wrote. “One study found that ED visits for these injuries during the 1993 to 2008 period varied by age group, ranging from 1.1 to 9.6 per 1,000 ED visits, with adolescents aged 15 to 19 years exhibiting the highest rates.”

To assess trends in nonfatal self-inflicted injuries treated in EDs among children, adolescents and young adults, researchers analyzed secondary data from the National Injury Surveillance System-All Injury Program, which collects data on all first-time visits for nonfatal injuries in 66 U.S. hospital EDs.

From 2001 to 2015, there were 43,138 ED visits for self-inflicted injury among youth.

There was not a statistically significant trend in the overall weighted age-adjusted rate until 2008, increasing 5.7% (95% CI, 3-8.4) annually thereafter and reaching 303.7 per 100,000 population (95% CI, 254.1-353.3) in 2015.

Overall age-adjusted rates for females did not exhibit statistical significance until 2009, and increased 8.4% (95% CI, 5.6-11.2) yearly from 2009 to 2015.

After 2009, rates among females aged 10 to 14 years increased 18.8% (95% CI, 12.1-25.8) per year, from 109.8 (95% CI, 69.9-149.7) in 2009 to 317.7 (95% CI, 230.3-405.1) per 100,000 population in 2015.

From 2008 to 2015, rates among females aged 15 to 19 years increased by 7.2% (95% CI, 3.8-10.8) per year.

From 2001 to 2015, rates among females aged 20 to 24 years increased 2%(95% CI, 0.8-3.1) per year.

Trends for all self-inflicted injury methods remained stable among males.

The most common method of self-inflicted injury for females was poisoning, with rates remaining stable until 2007 and increasing 5.3% (95% CI, 0.5-10.4) each year.

Among females, rates for self-inflicted injuries by sharp object increased 7.1% (95% CI, 5.2-8.9) annually throughout from 2001 to 2015, while rates for blunt object injuries remained stable from 2006 to 2015.

“These findings underscore the need for the implementation of evidence-based, comprehensive suicide and self-harm prevention strategies within health systems and communities,” the researchers wrote. “These strategies include strengthening access to and delivery of care for suicidal youth within health systems and creating protective environments, promoting youth connectedness, teaching coping and problem-solving skills, and identifying and supporting at-risk youth within communities.” – by Amanda Oldt

Disclosures: The authors report no relevant financial disclosures.