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Factors predicting meaningful suicide attempts: multiple attempts and index methods

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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.

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.

참고문헌 (12)

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  4. Runeson B, "Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study", BMJ, 341, pp.c3222~ (2010)
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  7. Rahman F, "Risk factors for selfharm repetition in adolescents : a systematic review", Clin Psychol Rev, 88, pp.102048~ (2021)
  8. Runeson B, "Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study", BMJ, 341, pp.c3222~ (2010)
  9. Lim M, "Difference in suicide methods used between suicide attempters and suicide completers", Int J Ment Health Syst, 8, pp.54~ (2014)
  10. Klonsky ED, "Nonsuicidal self-injury : what we know, and what we need to know", Can J Psychiatry, 59, pp.565~568 (2014)
  11. Parellada M, "Is attempted suicide different in adolescent and adults?", Psychiatry Res, 157, pp.131~137 (2008)
  12. Ligier F, "Recurrence of suicide attempt in adolescents lost to contact early by clinicians : the 10-year REPEATERS cohort of French adolescents", J Adolesc, 43, pp.111~118 (2015)

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