Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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Characteristics of First Visit Pediatric Patients with Suicidal Ideation and Behavior: An 8-Year Retrospective Chart Review

  • Song, Jungeun (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Kweon, Yong-Sil (Suicide and School Mental Health Institute) ;
  • Hong, Sung Hee (Suicide and School Mental Health Institute) ;
  • Kim, Joonbeom (Suicide and School Mental Health Institute) ;
  • Chun, Ka Hye (Department of Psychiatry, Hallym University Sacred Heart Hospital) ;
  • Bahn, Geon Ho (Department of Psychiatry, Kyung Hee University School of Medicine) ;
  • Yook, Ki-Hwan (Department of Psychiatry, Bundang CHA Hospital, School of Medicine, CHA University) ;
  • Shin, Dongwon (Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Hong, Hyun Ju (Suicide and School Mental Health Institute)
  • Received : 2020.07.07
  • Accepted : 2020.08.05
  • Published : 2020.10.01
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Abstract

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6-18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion: Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

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References

  1. Statistics Korea. Cause of death in 2018. Daejeon: Statistics Korea; 2019. p.8.
  2. Korean Centers for Disease Control & Prevention. Statistics of surveillance of health behavior in adolescents in 2019 [cited 2019 Dec 31]. Available from URL: https://www.cdc.go.kr/yhs/yhshmpg/main.do.
  3. Park S, Kim BN, Cho SC, Kim JW, Shin MS, Yoo HJ. Prevalence, correlates, and comorbidities of DSM-IV psychiatric disorders in children in Seoul, Korea. Asia Pac J Public Health 2015;27:NP1942-NP1951. https://doi.org/10.1177/1010539513475656
  4. Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry 2013;70:300-310. https://doi.org/10.1001/2013.jamapsychiatry.55
  5. Lee J, Bang YS, Min S, Ahn JS, Kim H, Cha YS, et al. Characteristics of adolescents who visit the emergency department following suicide attempts: comparison study between adolescents and adults. BMC Psychiatry 2019;19:231. https://doi.org/10.1186/s12888-019-2213-5
  6. Copeland WE, Goldston DB, Costello EJ. Adult associations of childhood suicidal thoughts and behaviors: a prospective, longitudinal analysis. J Am Acad Child Adolesc Psychiatry 2017;56: 958-965.e4. https://doi.org/10.1016/j.jaac.2017.08.015
  7. Reinherz HZ, Tanner JL, Berger SR, Beardslee WR, Fitzmaurice GM. Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromised functioning at age 30. Am J Psychiatry 2006;163:1226-1232. https://doi.org/10.1176/ajp.2006.163.7.1226
  8. Korean Centers for Disease Control & Prevention. Statistics of surveillance of health behavior in adolescent in 2017 [cited 2017 Dec 15]. Available from URL: https://www.cdc.go.kr/yhs/yhshmpg/main.do.
  9. Lee YJ, Bahn GH, Han J, Hong M. Prevalence of treated psychiatric disorders in Korean child and adolescent patients in 2012. In: American Academy of Child and Adolescent Psychiatry, editor. Annual Meeting of American Academy of Child and Adolescent Psychiatry; 2015; San Antonio: TX, USA. San Antonio: American Academy of Child and Adolescent Psychiatry;2015.
  10. Canadian Medical Association. 8th annual national report card on health care [cited 2008 Aug 18]. Available from URL: http://www.bc-psychologist.com/downloads/other/National_Report_Card_EN.pdf.
  11. Nabors LA, Reynolds MW. Program evaluation activities: Outcomes related to treatment for adolescents receiving school-based mental health services. J Child Serv Soc Pol Res Pract 2000;3:175-189.
  12. Hwang JW, Kim JW, Chung US, Hong HJ, Kim B. Screening for depression and suicidality in adolescents: The korean annual nationwide survey. JAACAP Connect 2020;7:10-14.
  13. Oh IS, Hong HJ, Kang YH, Lim I. Analysis on effectiveness of mental health professional's school visit service for intervention. J Res Educ 2017;30:227-258
  14. World Health Organization. The ICD-10 classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization;1992.
  15. Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, et al. Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 2011;50:32-45. https://doi.org/10.1016/j.jaac.2010.10.006
  16. Statistics Korea. Cause of death. Available from URL: http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01#SelectStatsBoxDiv.
  17. Wu P, Hoven CW, Bird HR, Moore RE, Cohen P, Alegria M, et al. Depressive and disruptive disorders and mental health service utilization in children and adolescents. J Am Acad Child Adolesc Psychiatry 1999;38:1081-1092. https://doi.org/10.1097/00004583-199909000-00010
  18. Calear AL, Batterham PJ, Christensen H. Predictors of help-seeking for suicidal ideation in the community: risks and opportunities for public suicide prevention campaigns. Psychiatry Res 2014;219:525-530. https://doi.org/10.1016/j.psychres.2014.06.027
  19. Sanchez AL, Cornacchio D, Poznanski B, Golik AM, Chou T, Comer JS. The effectiveness of school-based mental health services for elementary-aged children: a meta-analysis. J Am Acad Child Adolesc Psychiatry 2018;57:153-165. https://doi.org/10.1016/j.jaac.2017.11.022
  20. Boeninger DK, Masyn KE, Feldman BJ, Conger RD. Sex differences in developmental trends of suicide ideation, plans, and attempts among European American adolescents. Suicide Life Threat Behav 2010;40:451-464. https://doi.org/10.1521/suli.2010.40.5.451
  21. Ge X, Conger RD, Elder GH Jr. Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms. Dev Psychol 2001;37:404-417. https://doi.org/10.1037/0012-1649.37.3.404
  22. Rhodes AE, Khan S, Boyle MH, Wekerle C, Goodman D, Tonmyr L, et al. Sex differences in suicides among children and youth: the potential impact of misclassification. Can J Public Health 2012;103:213-217. https://doi.org/10.1007/BF03403815
  23. Renaud J, Seguin M, Lesage AD, Marquette C, Choo B, Turecki G. Service use and unmet needs in youth suicide: a study of trajectories. Can J Psychiatry 2014;59:523-530. https://doi.org/10.1177/070674371405901005
  24. Lee S, Tsang A, Breslau J, Aguilar-Gaxiola S, Angermeyer M, Borges G, et al. Mental disorders and termination of education in high-income and low- and middle-income countries: epidemiological study. Br J Psychiatry 2009;194:411-417. https://doi.org/10.1192/bjp.bp.108.054841
  25. Stoep AV, Weiss NS, Kuo ES, Cheney D, Cohen P. What proportion of failure to complete secondary school in the US population is attributable to adolescent psychiatric disorder? J Behav Health Serv Res 2003;30:119-124. https://doi.org/10.1007/BF02287817
  26. Benjet C, Menendez D, Albor Y, Borges G, Orozco R, Medina-Mora ME. Adolescent predictors of incidence and persistence of suicide- related outcomes in young adulthood: a longitudinal study of Mexican youth. Suicide Life Threat Behav 2018;48:755-766. https://doi.org/10.1111/sltb.12397
  27. Lee MK, Bhang SY, Ahn JH, Park JH, Choi HK. Successful schooling rate and satisfaction of the inpatient hospital school participants among the child and adolescent psychiatric inpatients in the closed ward. J Korean Acad Child Adolesc Psychiatry 2013;24:141-150. https://doi.org/10.5765/jkacap.2013.24.3.141
  28. Beautrais AL, Joyce PR, Mulder RT. Psychiatric contacts among youths aged 13 through 24 years who have made serious suicide attempts. J Am Acad Child Adolesc Psychiatry 1998;37:504-511. https://doi.org/10.1097/00004583-199805000-00013
  29. DeMaso DR, Ross L, Beardslee WR. Depressive disorders and suicidal intent in adolescent suicide attempters. J Dev Behav Pediatr 1994;15:74-77.
  30. Nrugham L, Larsson B, Sund AM. Specific depressive symptoms and disorders as associates and predictors of suicidal acts across adolescence. J Affect Disord 2008;111:83-93. https://doi.org/10.1016/j.jad.2008.02.010
  31. Sheftall AH, Asti L, Horowitz LM, Felts A, Fontanella CA, Campo JV, et al. Suicide in elementary school-aged children and early adolescents. Pediatrics 2016;138:e20160436. https://doi.org/10.1542/peds.2016-0436
  32. Marttunen MJ, Aro HM, Henriksson MM, Lonnqvist JK. Antisocial behaviour in adolescent suicide. Acta Psychiatr Scand 1994;89:167-173. https://doi.org/10.1111/j.1600-0447.1994.tb08087.x

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