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Childhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.
Aim
To determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.
Method
Population-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).
Results
Records were extracted for 2477 ‘cases’ and 24 777 ‘controls’; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10–17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4–3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7–7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aORmale = 8.17 (95% CI, 5.02–13.29), aORfemale = 15.08 (95% CI, 8.07–28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aORmale = 1.90 (95% CI, 1.64–2.21), aORfemale = 2.65 (95% CI, 1.94–3.62), and each mental health admission by aORmale = 2.06 (95% CI, 1.81–2.34), aORfemale = 1.78 (95% CI, 1.50–2.10).
Conclusions
Our lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential ‘at-risk’ adolescents to prevent future suicidal acts, especially those in general hospitals.
The theory of representations of finite simple groups of Lie type in defining characteristic is somewhat advanced. The representations arise from those of the associated algebraic groups, and so some familiarity with the theory of algebraic groups is necessary in order to understand it. For an introduction to this theory see, for example, the survey article by Humphreys [51]. The enthusiastic reader may wish to consult Jantzen [58] for a more detailed exposition. Humphrey's classic book [50] provide a general exposition of the theory of algebraic groups and their representations, whilst Malle and Testerman's book [91] gives an excellent introduction to the general theory, subgroup structure, and representation theory of the finite and algebraic groups of Lie type, including a fuller discussion of all of the introductory material in this chapter.
In many respects, the study of the J2-candidates is easier than that of the J1-candidates, simply because there are far fewer of them: we just need to know about the representations in dimensions up to 12, and to be able to determine some of their properties, such as forms preserved and their behaviour under the actions of group and field automorphisms. Fortunately it is possible to extract this information starting from a superficial familiarity with the main results of the theory, principally the Steinberg Tensor Product Theorems. These theorems, together with the tables in [84], suffice to determine the representations.
This book classifies the maximal subgroups of the almost simple finite classical groups in dimension up to 12; it also describes the maximal subgroups of the almost simple finite exceptional groups with socle one of Sz(q), G2(q), 2G2(q) or 3D4(q). Theoretical and computational tools are used throughout, with downloadable Magma code provided. The exposition contains a wealth of information on the structure and action of the geometric subgroups of classical groups, but the reader will also encounter methods for analysing the structure and maximality of almost simple subgroups of almost simple groups. Additionally, this book contains detailed information on using Magma to calculate with representations over number fields and finite fields. Featured within are previously unseen results and over 80 tables describing the maximal subgroups, making this volume an essential reference for researchers. It also functions as a graduate-level textbook on finite simple groups, computational group theory and representation theory.
1. This paper contains a number of investigations, more or less connected, on the theory of systems of circles. In such a well-worn field one does not expect to have hit upon much that is absolutely new, but it may be hoped that there is sufficient freshness of treatment to give the paper some interest even where it deals with results already known.
In a paper under the above title in Vol. XXIV. of the Proceedings it is shown that in a certain system of co-ordinates, the equation of the first degree represents a circle orthogonal to a fixed circle. It follows that any purely graphical theorem regarding right lines in a plane can be extended to orthogonals to a circle. This may be seen otherwise by projecting the figure of right lines on a sphere, the right lines thus becoming circles orthogonal to a circle on the sphere; and then inverting the sphere into the original plane. The geometrical method shows that the extension may also be applied to theorems involving one circle as well as right lines, the circle remaining unchanged, while the lines become orthogonals to a circle; the Pole and Polar Theorem, Pascal's and Brianchon's Theorems are examples. But plane figures involving more than one circle cannot in general be transformed in this way. We cannot, for instance, deduce the construction for a circle touching three great circles on a sphere from the known construction for a circle touching three lines in a plane; nor the Gergonne construction for circles on a sphere from the corresponding method in a plane.
1. By a quantitative proof of an inequality I mean one which exhibits the difference between the two magnitudes compared in a form which shows at a glance whether the difference is positive or negative. Such a proof not merely establishes the existence of the inequality, but also gives a measure of its amount.
It is an obvious remark that the Mathieu functions, being the harmonic functions of the elliptic cylinder, must be closely related to the Bessel functions, the harmonic functions of the circular cylinder. Reference has been made to some aspects of this relationship in two earlier communications, to which the present paper may be regarded as a sequel.