Factors associated with gender specific adolescent presentations to the emergency department for suicide risk behaviors during the COVID-19 pandemic
Bibliographic record
Abstract
Background Adolescent presentations to the emergency department (ED) for suicide-related thoughts and behaviors (SRTBs) increased during the COVID-19 pandemic. Gender expansive youth were particularly impacted by the loss of gender-specific services, however, data examining ED pandemic presentations of gender expansive youth for SRTBs are scarce. Methods Data were collected at a tertiary care center in Canada. Adolescents aged 12 to 17 presenting with SRTBs were recruited during two periods: March 2018 - March 2020 (pre-pandemic) and March 2021 - May 2023 (during pandemic). Patient demographics, mental health symptoms, and pre-ED visit healthcare utilization were examined. Results We identified 202 adolescents (70 pre-pandemic; 132 during pandemic), with a mean age of 14.3 years. Compared with pre-pandemic, during pandemic adolescents were more likely to identify as gender expansive [pre: 5.7% versus during: 24.2%; p = .01] and were of European descent [pre: 28.6% versus during: 59.1%; p < .01]. During the pandemic, gender expansive adolescents, on average, exhibited higher suicidal ideation, measured by Suicide Ideation Questionnaire Junior scores, compared with cisgender adolescents [gender expansive: mean = 64.3 (standard deviation = 12.1) versus cisgender participants: mean = 58.0 (standard deviation = 14.5); p = .03]. There were no differences in demographics, healthcare utilization, depression or anxiety symptom severity between gender expansive and cisgender adolescents. Conclusions Adolescents presenting to the ED with SRTBs during the pandemic were more likely to identify as gender expansive than those presenting pre-pandemic. Gender expansive adolescents exhibited increased suicidal ideation compared to cisgender adolescents during the pandemic.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".