Self-injurious behavior and related mortality in children under 10 years of age: a retrospective health record study in Brazil

Abstract

Objective: To describe and analyze data on self-injurious behavior (SIB) and related mortality in children under 10 years old in Brazil. Methods: A descriptive study was performed using secondary public health care data extracted from the Hospital Information System (Sistema de Informac¸õ es Hospitalares, SIH) and Mortality Information System (Sistema de Informac¸õ es sobre Mortalidade, SIM) in Brazil. The databases are available for online access at http://datasus.saude.gov.br/. Results: In Brazil, according to SIH data, 11,312 hospitalizations of patients under 10 years of age were recorded from 1998 to 2018 as resulting from SIB (ICD-10 X60-X84 codes). Of these, 65 resulted in death. According to the SIM, from 1996 to 2016, 91 deaths related to SIB were recorded, 81 (89%) in children aged 5 to 9 years, nine (9.9%) in children aged 1 to 4 years, and one (1.1%) in a child below 1 year of age. Conclusion: These results highlight the relevance of creating measures to better understand SIB and related mortality in this age group. They also reveal the vulnerability of children in Brazil and warrant further studies to address these issues.

Self-harm in children 12 years and younger: characteristics and outcomes based on the Multicentre Study of Self-harm in England

“…In a study in Australia, Mitchel et al [ 4 ] found that 76% of the 6–10-year old in their sample of hospital admitted individuals were boys. This excess of boys was also found in a large register-based study in Brazil of admissions to hospital of under 10-year olds with self-harm [ 5 ].…”

“…Reporting on data from a national register on hospital admissions in Australia, Mitchell and colleagues recently showed that three-quarters of individuals aged 6–10 years who presented with self-harm were boys [ 4 ]. Studart-Botto et al [ 5 ] described self-injurious behaviour in a large population of Brazilian children under 10 years who were registered in hospital systems between 1996 and 2018. In their 5–9-year-old children, boys outnumbered girls.…”

“…In terms of methods used for self-harm, Pfeffer et al [ 1 ] found that in children receiving care on a psychiatric ward 38% of those who self-harmed had jumped, 25% self-poisoned, 23% had burnt themselves and 13% had stabbed themselves. In the Australian study of Mitchell and colleagues [ 4 ] of hospital admissions with self-harm, self-poisoning was the most common method, as was the case in the study involving hospital registered self-harm of children under 10 years in Brazil [ 5 ].…”

Self-harm in primary school-aged children: Prospective cohort study

“…Additionally, we scrutinised all participants’ free-text descriptions of self-reported self-harm events in order to improve case ascertainment. Unlike many previous studies [ 13 , 16 , 18 ], our sample was a non-treatment-seeking sample and participants did not need to have sought medical help for self-harm to have been included. Our study also contained some potential limitations.…”

“…As such, the occurrence of self-harm in pre-teen children is a particularly concerning event [5,6]. Yet to date, knowledge about self-harm in young people derives almost exclusively from adolescent populations [7][8][9][10][11][12], and few studies have examined selfharm in non-treatment-seeking young people aged 12 years or under [13][14][15][16][17][18]. This is a key period in the life course when the first symptoms of common mental disorders, such as depression and anxiety, begin to emerge [19,20].…”