Suicidal ideation and intentional self-inflicted injury in autism spectrum disorder and intellectual disability: An examination of trends in youth emergency department visits in the United States from 2006 to 2014.
Paige E Cervantes, Derek S Brown, Sarah M Horwitz
PMID 35608134WHAT IT FOUND
Emergency visits by autistic youth and youth with intellectual disability more often coded for suicidal thoughts or self-inflicted injury than other youth.
Autistic visits had highest rates in 7 to 12 and 13 to 18; intellectual disability visits had highest rates in 19 to 25.
Key findings
01Emergency visits by youth with intellectual disability (6.6%) and autistic youth (5.1%) more often had a suicidal ideation or intentional self-inflicted injury diagnosis than visits by youth without these diagnoses (1.2%).
02The age pattern differed: autistic visits had higher rates than intellectual disability visits at ages 7 to 12 (2.0% vs 1.3%) and 13 to 18 (7.2% vs 5.8%), while intellectual disability visits had higher rates at ages 19 to 25 (8.3% vs 7.4%).
03From 2006 to 2014, rates of these diagnoses rose in all groups, with larger increases in autistic and intellectual disability visits than in comparison visits.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study looked only at youth emergency department visits, so it cannot describe autistic youth or youth with intellectual disability who do not go to the emergency department. Diagnoses were coded in routine emergency care, not by a standard assessment, and the paper says this likely underestimates true prevalence. The coding did not distinguish suicidal intent from non-suicidal self-inflicted injury. Only about 9% of autistic visits also had intellectual disability coded, which is lower than expected and may mean co-occurring intellectual disability was missed. The database has no race or ethnicity data and does not track repeat emergency visits. The data ended in 2014, so later trends are not included. The comparison group may have included youth with other psychiatric or neurodevelopmental diagnoses, and possibly undiagnosed autistic youth.
Declared interests
The supplied article text does not include a conflicts-of-interest statement. The publication types list NIH extramural research support.
The easy way to misread this
Do not read these emergency visit percentages as the true suicide rate for autistic youth or youth with intellectual disability. They count only coded emergency visits, and the paper says emergency department coding likely underestimates true prevalence.