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JAMA NetworkTrends and Seasonality of Emergency Department Visits and Hospitalizations for Suicidality Among Children and Adolescents in the US from 2016 to 2021

How did the COVID-19 pandemic and subsequent school closures impact seasonal patterns of suicidality among US children and adolescents?

Understanding the patterns of suicidality among children and adolescents can provide valuable insights for clinicians and public health officials. This study looks into the trends and seasonality of emergency department visits and hospitalizations for suicidality among this demographic, especially in the context of the COVID-19 pandemic and its impact on school closures.

Study Design:

  • Population-based, descriptive cross-sectional study.
  • Utilized administrative claims data from Optum’s deidentified Clinformatics Data Mart Database.
  • Participants: Children aged 10-12 years and adolescents aged 13-18 years.
  • Coverage period: January 1, 2016, to December 31, 2021.
  • Statistical analysis conducted between April and November 2022.
  • Exposures: Month of the year and the COVID-19 pandemic.

Key Findings:

  • 73,123 ED visits and hospitalizations for suicidality reported from 2016 to 2021.
  • 66.1% of these events were reported for females.
  • Mean age at the time of the event: 15.4 years.
  • Mean annual incidence of ED visits and hospitalizations for suicidality was 964 per 100,000 children and adolescents.
  • Incidence increased from 760 per 100,000 in 2016 to 1,006 per 100,000 in 2019.
  • Temporary decrease to 942 per 100,000 in 2020, followed by an increase to 1,160 per 100,000 in 2021.
  • Seasonal patterns (pre-COVID-19 and 2021): Peaks in April and October, lowest in July.
  • Disrupted seasonal patterns in spring 2020 (school closures): Lowest rates in April and May.


  • The study found seasonal patterns in suicidality among children and adolescents.
  • An unexpected decrease in suicidality was observed after COVID-19–related school closures in March 2020, suggesting a potential association between suicidality and the school calendar.

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Did You Know?
Adolescent suicide rates have been steadily increasing over the past decade, making it the second leading cause of death among individuals between the ages of 10 and 24.

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