Objectives
Emergency department visits among youth for suicidal ideation have increased since the start of the COVID-19 pandemic. Our objective was to identify potential risk factors for these increased rates by investigating components of the adverse childhood experiences (ACEs) criteria, which have been associated with psychiatric morbidity.
Methods
This retrospective chart review included patients under 19 years old (ages 3-18 years) evaluated in the Comprehensive Psychiatric Emergency Program in a Brooklyn public hospital from January through February in 2020 (hereafter, pre–COVID-19) and from corresponding months in 2021 (hereafter, COVID-19). Relevant items from the Child-Adolescent Suicide Potential Index (CASPI), which staff administered to patients, were used to develop a proxy for the ACEs categories (hereafter, ACE-proxy) including physical and emotional abuse, domestic violence, parental alcohol use, and mental illness. Individual items and total scores of the ACE-proxy were compared between cohorts using χ2 and t tests, respectively.
Results
The sample of 338 patients had comparable age (13.48 vs 14.02), gender (50.7% vs 53.7% female), and race (73.7% vs 66.9% Black or African American) distributions among the pre–COVID-19 and COVID-19 cohorts. A total of 266 (67%) patients completed the CASPI and were included in the analyses, with 165 seen pre–COVID-19 and 101 during COVID-19. Comparing cohorts, the ACE-proxy items and total scores were increased in the COVID-19 group, except for the emotional abuse item as follows: physical 26 (15.8%) vs 22 (22.2%) and emotional 71 (43.0%) vs 42 (42.0%) abuse, domestic violence 12 (7.3%) vs 8 (7.9%), parental drinking alcohol 23 (14.0%) vs 21 (21.0%), and parental sadness 35 (21.3%) vs 28 (28.0%). The mean total of the ACE-proxy was 1.02 (± 1.20) vs 1.21 (± 1.40). None of the comparisons reached statistical significance.
Conclusions
To optimize treatment of youth experiencing suicidal ideations, specific risk factors should be identified. Components of the ACEs criteria were shown to have increased during the pandemic; therefore, services targeting youth who experience physical abuse and exposure to substance use by parents are even more critical at this time. Further research should be done with larger sample sizes to identify potential statistically significant risk factors.
RF, S, ADOL