Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical Characteristics of Adolescents Hospitalized Through Emergency Room for Intentional Self-Harm or Suicide Attempts

  • Yoon, Tae Yeon (Department of Psychiatry, Gongju National Hospital) ;
  • Lee, Hyun Sook (Department of Health Administration, Kongju National University) ;
  • Son, Jung-Woo (Department of Neuropsychiatry, Chungbuk National University College of Medicine) ;
  • Kim, Sang Mi (Department of Health Management, College of Medical Sciences, Jeonju University) ;
  • Lee, Je Jung (Department of Psychiatry, Gongju National Hospital)
  • Received : 2022.03.02
  • Accepted : 2022.05.10
  • Published : 2022.07.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study aimed to investigate the clinical characteristics of adolescents hospitalized through the emergency room for intentional self-harm or suicide attempts. Methods: This retrospective study used data from the Korean National Hospital Discharge In-depth Injury Survey conducted between 2006 and 2018 for individuals aged 10-24 years. The clinical characteristics of the patients were analyzed and compared across sex and age groups using the Rao-Scott chi-square tests and multiple logistic regression analysis for complex survey data. Results: The most common psychiatric diagnosis was mood disorder (22.0%), and more female patients were diagnosed with it than male patients (p=0.010). The 19-24 years age group was diagnosed with mood disorder the most compared to other younger groups (p=0.012). Male patients used lethal methods more than female patients (p=0.008), and the 19-24 years age group used more drug poisoning and cutting or piercing (p<0.001) for intentional self-harm or suicide attempts than younger groups. Conclusion: Adolescents hospitalized for intentional self-harm or suicide attempts showed significant differences in clinical characteristics across sex and age groups. These findings suggest that measures for preventing self-harm or suicide attempts need to be differentiated according to the sex and age of adolescents.

Keywords

References

  1. Nock MK. Understanding nonsuicidal self-injury: origins, assessment, and treatment. Washington, DC: American Psychological Association;2009.
  2. Goldman-Mellor S, Olfson M, Lidon-Moyano C, Schoenbaum M. Association of suicide and other mortality with emergency department presentation. JAMA Netw Open 2019;2:e1917571.
  3. Horwitz AG, Czyz EK, King CA. Predicting future suicide attempts among adolescent and emerging adult psychiatric emergency patients. J Clin Child Adolesc Psychol 2015;44:751-761. https://doi.org/10.1080/15374416.2014.910789
  4. Ministry of Health and Welfare, Korea Foundation for Suicide Prevention. 2021 white paper on suicide prevention. Sejong: Korea Foundation for Suicide Prevention;2021.
  5. Hong K. Korean textbook of child psychiatry. Seoul: Hakjisa;2014.
  6. Roh BR, Jung EH, Hong HJ. A comparative study of suicide rates among 10-19-year-olds in 29 OECD countries. Psychiatry Investig 2018;15:376-383. https://doi.org/10.30773/pi.2017.08.02
  7. Park S, Cho SC, Kim BN, Kim JW, Yoo HJ, Hong JP. Increased use of lethal methods and annual increase of suicide rates in Korean adolescents: comparison with adolescents in the United States. J Child Psychol Psychiatry 2014;55:258-263. https://doi.org/10.1111/jcpp.12148
  8. Song KJ, Hong KJ. Development of emergency medical service model for suicidal attempt. Sejong: Ministry of Health and Welfare;2019.
  9. Cha JH, Ahn ME, Kim DW, Lee SK, Lee CH, Kim SM, et al. Clinical characteristics of intentional self-harm inpatient with lethal methods. J Korean Soc Emerg Med 2019;30:419-427.
  10. Ministry of Health and Welfare, Korea Foundation for Suicide Prevention. 2018 National survey on suicide. Sejong: Ministry of Health and Welfare;2018. p.269.
  11. Korea Centers for Disease Control and Prevention. 2015 Korean National Hospital discharge in-depth injury survey. Cheongju: Korea Centers for Disease Control and Prevention;2015.
  12. Statistics Korea. Korean standard classification of diseases. Daejeon: Statistics Korea;2020.
  13. Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. Lancet Child Adolesc Health 2018;2:223-228. https://doi.org/10.1016/S2352-4642(18)30022-1
  14. Spicer RS, Miller TR. Suicide acts in 8 states: incidence and case fatality rates by demographics and method. Am J Public Health 2000;90:1885-1891. https://doi.org/10.2105/AJPH.90.12.1885
  15. Kim SH, Kim KK. Comparisons of analysis methods for complex sampling data. Journal of the Korean Data Analysis Society 2017; 19:2469-2480. https://doi.org/10.37727/jkdas.2017.19.5.2469
  16. Kim H, Ryu JM, Kim HW. Characteristics and trends of suicide attempt or non-suicidal self-injury in children and adolescents visiting emergency department. J Korean Med Sci 2020;35:e276.
  17. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al. Suicide prevention strategies: a systematic review. JAMA 2005; 294:2064-2074. https://doi.org/10.1001/jama.294.16.2064
  18. Bi B, Tong J, Liu L, Wei S, Li H, Hou J, et al. Comparison of patients with and without mental disorders treated for suicide attempts in the emergency departments of four general hospitals in Shenyang, China. Gen Hosp Psychiatry 2010;32:549-555. https://doi.org/10.1016/j.genhosppsych.2010.06.003
  19. Hurry J, Storey P. Assessing young people who deliberately harm themselves. Br J Psychiatry 2000;176:126-131. https://doi.org/10.1192/bjp.176.2.126
  20. Health Insurance Review & Assessment Service. Status of hospitalization rooms by type [Internet]. Wonju: Health Insurance Review & Assessment Service [cited 2021 Oct 26]. Available from: http://opendata.hira.or.kr/op/opc/olapMdclRcStatsInfo.do.
  21. Kashani JH, Orvaschel H, Rosenberg TK, Reid JC. Psychopathology in a community sample of children and adolescents: a developmental perspective. J Am Acad Child Adolesc Psychiatry 1989; 28:701-706. https://doi.org/10.1097/00004583-198909000-00010
  22. Jacobsen LK, Rabinowitz I, Popper MS, Solomon RJ, Sokol MS, Pfeffer CR. Interviewing prepubertal children about suicidal ideation and behavior. J Am Acad Child Adolesc Psychiatry 1994;33: 439-452. https://doi.org/10.1097/00004583-199405000-00001
  23. Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock's comprehensive textbook of psychiatry. 10th ed. Philadelphia: Lippincott Williams & Wilkins;2017.
  24. Steele MM, Doey T. Suicidal behaviour in children and adolescents. Part 1: etiology and risk factors. Can J Psychiatry 2007;52(6 Suppl 1):21S-33S.
  25. Lee CA, Choi SC, Jung KY, Cho SH, Lim KY, Pai KS, et al. Characteristics of patients who visit the emergency department with selfinflicted injury. J Korean Med Sci 2012;27:307-312. https://doi.org/10.3346/jkms.2012.27.3.307
  26. Korean Academy of Child and Adolescent Psychiatry. Adolescent psychiatry. Seoul: Sigmapress;2012.
  27. Park JY, Kim JK. The effects of life stress on university students suicide and depression. Korean Journal of Youth Studies 2014;21: 167-189.
  28. Mercado MC, Holland K, Leemis RW, Stone DM, Wang J. Trends in emergency department visits for nonfatal self-inflicted injuries among youth aged 10 to 24 years in the United States, 2001-2015. JAMA 2017;318:1931-1933. https://doi.org/10.1001/jama.2017.13317
  29. Cibis A, Mergl R, Bramesfeld A, Althaus D, Niklewski G, Schmidtke A, et al. Preference of lethal methods is not the only cause for higher suicide rates in males. J Affect Disord 2012;136:9-16. https://doi.org/10.1016/j.jad.2011.08.032
  30. Canner JK, Giuliano K, Selvarajah S, Hammond ER, Schneider EB. Emergency department visits for attempted suicide and self harm in the USA: 2006-2013. Epidemiol Psychiatr Sci 2018;27:94-102. https://doi.org/10.1017/S2045796016000871