Pediatr Emerg Med J.  2023 Jan;10(1):31-35. 10.22470/pemj.2022.00472.

Factors predicting meaningful suicide attempts: multiple attempts and index methods

Affiliations
  • 1Department of Pediatrics, Dankook University Hospital, Cheonan, Republic of Korea
  • 2Department of Emergency Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
  • 3Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
  • 4Department of Pediatrics, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea

Abstract

Purpose
This study investigated the association of the index method, defined as the method used in the first suicide attempt (SA), with the outcome of SAs among adolescents.
Methods
The study analyzed medical records of 227 adolescents aged 10-18 years with clear SAs who visited the emergency department of Severance Hospital in Seoul, Korea from January 2007 through February 2021, focusing on the index methods and meaningful SAs defined as hospitalization, death or transfer to another hospital for psychiatric hospitalization. The association of the index method with the meaningful SAs was quantified using logistic regression.
Results
Among the 227 adolescents, 80 underwent the meaningful SAs (35.2%). The adolescents with the meaningful SA chose drug intoxication, fall, and hanging as the index methods more frequently than those without the outcome, whereas they showed a reverse pattern in cutting (P < 0.001). The association of fall or cutting with the meaningful SAs remained significant after adjustment (fall: adjusted odds ratio, 6.93 [95% confidence interval, 1.70-28.26]; cutting: 0.39 [0.17-0.91]; compared with those undergoing drug intoxication). Multiple SAs were also associated with the meaningful SA (1.76 [1.04-3.13]).
Conclusion
This study identifies the index method and multiple SAs as factors associated with the meaningful SA among adolescents in the emergency department. This finding may be helpful in interviewing adolescents with SAs.

Keyword

Adolescent; Patient Reported Outcome Measures; Poisoning; Suicide, Attempted; Suicide, Completed

Figure

  • Fig. 1. Flowchart for the selection of study population. SA: suicide attempt.


Reference

References

1. Mirkovic B, Cohen D, Garny de la Rivière S, Pellerin H, Guilé JM, Consoli A, et al. Repeating a suicide attempt during adolescence: risk and protective factors 12 months after hospitalization. Eur Child Adolesc Psychiatry. 2020; 29:1729–40.
2. Hultén A, Jiang GX, Wasserman D, Hawton K, Hjelmeland H, De Leo D, et al. Repetition of attempted suicide among teenagers in Europe: frequency, timing and risk factors. Eur Child Adolesc Psychiatry. 2001; 10:161–9.
3. Bergen H, Hawton K, Waters K, Ness J, Cooper J, Steeg S, et al. How do methods of non-fatal self-harm relate to eventual suicide? J Affect Disord. 2012; 136:526–33.
4. Runeson B, Tidemalm D, Dahlin M, Lichtenstein P, Långström N. Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study. BMJ. 2010; 341:c3222.
5. Wang LJ, Huang YC, Lee SY, Wu YW, Chen CK. Switching suicide methods as a predictor of completed suicide in individuals with repeated self-harm: a community cohort study in northern Taiwan. Aust N Z J Psychiatry. 2015; 49:65–73.
6. Daly C, Griffin E, McMahon E, Corcoran P, Webb RT, Witt K, et al. Repeat self-harm following hospital-presenting intentional drug overdose among young people-a national registry study. Int J Environ Res Public Health. 2020; 17:6159.
7. Rahman F, Webb RT, Wittkowski A. Risk factors for self-harm repetition in adolescents: a systematic review. Clin Psychol Rev. 2021; 88:102048.
8. Runeson B, Tidemalm D, Dahlin M, Lichtenstein P, Långström N. Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study. BMJ. 2010; 341:c3222.
9. Lim M, Lee SU, Park JI. Difference in suicide methods used between suicide attempters and suicide completers. Int J Ment Health Syst. 2014; 8:54.
10. Klonsky ED, Victor SE, Saffer BY. Nonsuicidal self-injury: what we know, and what we need to know. Can J Psychiatry. 2014; 59:565–8.
11. Parellada M, Saiz P, Moreno D, Vidal J, Llorente C, Alvarez M, et al. Is attempted suicide different in adolescent and adults? Psychiatry Res. 2008; 157:131–7.
12. Ligier F, Guillemin F, Angot C, Bourion S, Kabuth B. Recurrence of suicide attempt in adolescents lost to contact early by clinicians: the 10-year REPEATERS cohort of French adolescents. J Adolesc. 2015; 43:111–8.
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