Background
Studies investigating the association between injuries and mental health have mainly focused on mental health sequelae of
injuries. The aim of this prospective cohort study was to assess the incidence and risk factors of physical injury hospitalisation
and poisoning hospitalisation among adolescent psychiatric outpatients.
Subjects and methods
Data on 302 consecutively referred Finnish psychiatric outpatients aged 12–22 years (mean 16) were collected at treatment
entry. The end-point of the average 11-year follow-up was death or end of follow-up on 31 December 2005. The main outcome
variables were physical injury hospitalisation and poisoning hospitalisation.
Results
Altogether 111 physical injury hospitalisations occurred in 65 (22% of all) persons during follow-up, incidence being 27.9
(95% CI: 22.7–33.1) per 1,000 person-years. Poisoning hospitalisation occurred in 22 (7.3%) persons, altogether 50 times,
incidence being 12.6 (95% CI: 9.1–16.0). Seven injury-related deaths occurred, incidence being 1.8 (95% CI: 0.5–3.1) per 1,000
person-years. The most common physical injury types were fractures (40%), followed by distortions (10%) and wounds (10%),
while poisoning for drugs accounted for 72% of the poisonings. Previous inpatient care, psychotropic medication, suicidality,
and major depression were associated with poisoning hospitalisation during the follow-up while only gender was associated
with physical injury hospitalisation.
Conclusion
Injuries cause significant morbidity among psychiatric outpatients, but only poisonings seem to be related with suicidality
in Finnish adolescent psychiatric outpatients. The high frequency of injuries seems to justify clinicians’ attention to these
aspects when assessing the need for care among young people.
Key words suicidality - adolescence - wounds and injuries - risk factors - cohort study - psychiatric treatment