Clinical and demographic risk profiles of non-suicidal self-injury among pediatric emergency department presentations: a three-year retrospective study.

objectiveThis study aimed to evaluate the sociodemographic characteristics and clinical profiles of pediatric patients presenting to an emergency department (ED) with non-suicidal self-injury (NSSI).

methodsThis retrospective case-control study included 36 children presenting to the ED with NSSI and 50 age- and sex-comparable controls presenting with non-psychiatric complaints between 2019 and 2022. Sociodemographic and clinical data were extracted from hospital records.

resultsThe mean age of the NSSI group was 15.58 ± 1.61 years, and 80.6% of the patients were female. The most frequently reported methods were self-poisoning and self-cutting. The age-at-onset distribution demonstrated a distinct peak at age 15 (52.8%), with a secondary peak at age 10 (22.2%). Logistic regression analysis demonstrated that increasing age was associated with a lower likelihood of NSSI presentation (OR = 0.718), whereas female sex was independently associated with NSSI (OR = 8.090; p < 0.001). The model explained 30.4% of the variance. More than half of the patients were receiving psychotropic medication at the time of ED admission, and a notable proportion had a family history of psychiatric disorders or suicide.

conclusionThe findings suggest that pediatric NSSI presentations are not isolated events but are frequently accompanied by ongoing psychiatric vulnerability, recurrent emergency department utilization, and psychotropic treatment. The observed age-at-onset pattern, characterized by a peak at age 15 and a secondary peak at age 10, indicates that vulnerability to NSSI may emerge during different developmental periods. Emergency departments represent a critical setting for psychiatric assessment, referral, and continuity of care for vulnerable children and adolescents.