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dc.contributor.authorWidnall, Emily
dc.contributor.authorEpstein, Sophie
dc.contributor.authorPolling, Catherine
dc.contributor.authorVelupillai, Sumithra
dc.contributor.authorJewell, Amelia
dc.contributor.authorDutta, Rina
dc.contributor.authorSimonoff, Emily
dc.contributor.authorStewart, Robert
dc.contributor.authorGilbert, Ruth
dc.contributor.authorFord, Tamsin Jane
dc.contributor.authorHotopf, Matthew
dc.contributor.authorHayes, Richard D
dc.contributor.authorDowns, Johnny
dc.date.accessioned2022-04-29T15:00:42Z
dc.date.available2022-04-29T15:00:42Z
dc.date.issued2022-04-29
dc.date.submitted2021-08-13
dc.identifier.issn1741-7015
dc.identifier.others12916-022-02329-w
dc.identifier.other2329
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/336616
dc.descriptionFunder: Psychiatry Research Trust Peggy Pollak Research Fellowship in Developmental Psychiatry
dc.descriptionFunder: MQ: Transforming Mental Health; doi: http://dx.doi.org/10.13039/100011705
dc.descriptionFunder: Psychiatry Research Trust
dc.descriptionFunder: NIHR Senior Investigator Award
dc.descriptionFunder: NIHR Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust
dc.descriptionFunder: NIHR
dc.description.abstractBACKGROUND: Individuals with autism spectrum disorder (ASD) are at particularly high risk of suicide and suicide attempts. Presentation to a hospital with self-harm is one of the strongest risk factors for later suicide. We describe the use of a novel data linkage between routinely collected education data and child and adolescent mental health data to examine whether adolescents with ASD are at higher risk than the general population of presenting to emergency care with self-harm. METHODS: A retrospective cohort study was conducted on the population aged 11-17 resident in four South London boroughs between January 2009 and March 2013, attending state secondary schools, identified in the National Pupil Database (NPD). Exposure data on ASD status were derived from the NPD. We used Cox regression to model time to first self-harm presentation to the Emergency Department (ED). RESULTS: One thousand twenty adolescents presented to the ED with self-harm, and 763 matched to the NPD. The sample for analysis included 113,286 adolescents (2.2% with ASD). For boys only, there was an increased risk of self-harm associated with ASD (adjusted hazard ratio 2·79, 95% CI 1·40-5·57, P<0·01). Several other factors including school absence, exclusion from school and having been in foster care were also associated with a higher risk of self-harm. CONCLUSIONS: This study provides evidence that ASD in boys, and other educational, social and clinical factors, are risk factors for emergency presentation with self-harm in adolescents. These findings are an important step in developing early recognition and prevention programmes.
dc.languageen
dc.publisherBioMed Central
dc.subjectResearch Article
dc.subjectChild and adolescent mental health
dc.subjectEpidemiology
dc.subjectAutism spectrum disorders
dc.subjectEducation
dc.subjectData linkage
dc.titleAutism spectrum disorders as a risk factor for adolescent self-harm: a retrospective cohort study of 113,286 young people in the UK.
dc.typeArticle
dc.date.updated2022-04-29T15:00:42Z
prism.issueIdentifier1
prism.publicationNameBMC Med
prism.volume20
dc.identifier.doi10.17863/CAM.84036
dcterms.dateAccepted2022-03-09
rioxxterms.versionofrecord10.1186/s12916-022-02329-w
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidEpstein, Sophie [0000-0002-2118-908X]
dc.contributor.orcidFord, Tamsin Jane [0000-0001-5295-4904]
dc.identifier.eissn1741-7015
pubs.funder-project-idNational Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, and a joint infrastructure grant from Guy’s and St Thomas’ Charity and the Maudsley Charity (BRC-2011-10035)
pubs.funder-project-idMRC Pathfinder award (MC_PC_17214)
pubs.funder-project-idNIHR Clinician Scientist Fellowship (CS-2018-18-ST2-014)
pubs.funder-project-idWelcome Trust Research Training Fellowship (105757/Z/14/Z)
pubs.funder-project-idMRC Clinical Research Training Fellowship (MR/T001437/1)


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