U.S. hospital emergency departments often under-diagnose mental disorders in children and young adults being treated for deliberate self-harm, researchers report.

The study of patients 7 to 24 years old found that just 56 percent of those who went to emergency departments to be treated for deliberate self-harm were diagnosed with a mental disorder and admitted to the hospital.

A diagnosis of depressive disorders -- a major risk factor for youth suicide -- was strongly associated with inpatient admission, the study said.

"In addition, 29 percent of the visits resulted in outpatient care referral; 5.8 percent resulted in referral to the emergency department for continuing care, and follow-up care was unspecified in 3.4 percent of the visits," wrote researchers from Columbia University Medical Center, in New York City. Their findings appear in the October issue of the journal Archives of General Psychiatry.

Deliberate self-harm, such as cutting, poisoning or piercing, is an important risk factor for subsequent suicide, the study noted.

"Mental disorders were diagnosed in roughly one-half of the emergency visits by young people treated for episodes of deliberate self-harm," the authors said. "This suggests substantial under-recognition of mental illness and likely inadequate referral for follow-up mental health care."

"Efforts should be made to fortify mental health assessments," they added. "One promising strategy involves routine administration of rapid and efficient diagnostic instruments to all young people following deliberate self-inflicted harm. Improving mental health assessment of these young people provides an important opportunity for secondary prevention."

More information of young people and self-harm

Reference Source 101
October 6, 2005