{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T23:56:04Z","timestamp":1773618964981,"version":"3.50.1"},"posted":{"date-parts":[[2024,12,3]]},"group-title":"Psychiatry and Clinical Psychology","reference-count":27,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,12,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Suicide and self-harm remain critical concerns in youth. This study compares patients with and without suicidality or self-harm (SOSH), suicidality (SI\/SA), and COVID-19 to investigate 53 pre-existing risk factors associated with suicidality in patients with and without COVID-19.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective case-control study was conducted using TriNetX data from 111,631,250 patients across 78 healthcare networks. This study included patients aged 0-21 with any healthcare visit between January 20, 2020, and May 11, 2023.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Comparison groups shared many risk factors, with specific differences. Children with SOSH and COVID-19 had higher odds of support group problems, personality disorder, thyroid disorders, and insomnia; children with SOSH without COVID-19 had higher odds of upbringing problems, anxiety and nonpsychotic disorders, sleep disorders, and autism. Adolescents with SOSH and COVID-19 had higher odds of parent-child conflict; adolescents with SOSH without COVID-19 had higher odds of education and literacy problems. Children with SI\/SA and COVID-19 had higher odds of support group problems, personality disorders, and asthma; children with SI\/SA without COVID-19 had higher odds of autism. Adolescents with SI\/SA and COVID-19 had higher odds of asthma. The effect size of COVID-19 was not significant. SOSH was associated with increased odds of prior SARS-CoV-2 infection in children (OR 2.42) and adolescents (OR 1.88).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>This study confirms known SOSH risk factors and demonstrates their association with suicidality. We observed a significant association between SOSH and preceding SARS-CoV-2 infection. This underscores the need to focus on suicide risk in youth affected by COVID-19.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.12.02.24318197","type":"posted-content","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T16:00:23Z","timestamp":1733241623000},"source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Suicidal Behavior in Youth and the Impact of SARS-CoV-2 Infection: A Retrospective Case-Control Study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9774-0790","authenticated-orcid":false,"given":"Kathleen P.","family":"Heslin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Montero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9217-3982","authenticated-orcid":false,"given":"Stephen V.","family":"Faraone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2104-0963","authenticated-orcid":false,"given":"Yanli","family":"Zhang-James","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"issue":"7","key":"2024120510211539000_2024.12.02.24318197v1.1","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1001\/jamapsychiatry.2020.0279","article-title":"National Trends in Mental Health Care for US Adolescents","volume":"77","year":"2020","journal-title":"JAMA Psychiatry"},{"key":"2024120510211539000_2024.12.02.24318197v1.2","unstructured":"Control. 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