본문 바로가기
KERD
논문KCI 등재

Increasing Trend and Characteristics of Korean Adolescents Presenting to Emergency Department for Self-Harm: A 5-Year Experience, 2015 to 2019

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose: Emergency department (ED) is a common treatment setting for adolescents with clinically serious self-harm. Here, we investigated the clinical characteristics and trends of adolescents with self-harm who visited the ED in one Korean university hospital. We also compared patients with a single ED visit to those with multiple ED visits to identify the risk factor of repeated visits. Materials and Methods: We retrospectively identified patients aged 12 to 18 years who presented to ED for self-harm from January 2015 to December 2019, based on electronic medical records. Self-harm included all thoughts and behaviors indicating intents to harm or hurt oneself, regardless of the degree of such attempt. Results: A total of 168 individuals (male:female=31:137; average 15.99±1.64 years) presented to ED following 304 episodes (45 and 259 episodes in males and females, respectively). The number of episodes steeply increased between 2016 and 2019, and the overall number during the study showed an increasing trend (p=0.043). Repeated ED visitors with self-harm showed more history of psychiatric treatment/admission (58.3% vs. 85.4%, p=0.002; 14.2% vs. 43.9%, p<0.001), history of child abuse (32.3% vs. 53.7%, p=0.013), and familial psychiatric history (13.4% vs. 31.7%, p=0.008) compared to those with a single visit. Conclusion: Among Korean adolescents, the number of ED visits and repetition of ED visits for self-harm is on the rise. For adolescents presenting to ED with self-harm, the history of psychiatric treatment/admission, child abuse, and familial psychiatric history should be properly obtained to identify the risk for multiple ED visits.

Abstract

Purpose: Emergency department (ED) is a common treatment setting for adolescents with clinically serious self-harm. Here, we investigated the clinical characteristics and trends of adolescents with self-harm who visited the ED in one Korean university hospital. We also compared patients with a single ED visit to those with multiple ED visits to identify the risk factor of repeated visits. Materials and Methods: We retrospectively identified patients aged 12 to 18 years who presented to ED for self-harm from January 2015 to December 2019, based on electronic medical records. Self-harm included all thoughts and behaviors indicating intents to harm or hurt oneself, regardless of the degree of such attempt. Results: A total of 168 individuals (male:female=31:137; average 15.99±1.64 years) presented to ED following 304 episodes (45 and 259 episodes in males and females, respectively). The number of episodes steeply increased between 2016 and 2019, and the overall number during the study showed an increasing trend (p=0.043). Repeated ED visitors with self-harm showed more history of psychiatric treatment/admission (58.3% vs. 85.4%, p=0.002; 14.2% vs. 43.9%, p<0.001), history of child abuse (32.3% vs. 53.7%, p=0.013), and familial psychiatric history (13.4% vs. 31.7%, p=0.008) compared to those with a single visit. Conclusion: Among Korean adolescents, the number of ED visits and repetition of ED visits for self-harm is on the rise. For adolescents presenting to ED with self-harm, the history of psychiatric treatment/admission, child abuse, and familial psychiatric history should be properly obtained to identify the risk for multiple ED visits.

참고문헌 (33)

  1. Hawton K, "Self-harm and suicide in adolescents", Lancet, 379, pp.2373~2382 (2012)
  2. Im Y, "Risk factors for suicide ideation among adolescents : five-year national data analysis", Arch Psychiatr Nurs, 31, pp.282~286 (2017)
  3. Carroll R, "Hospital presenting self-harm and risk of fatal and non-fatal repetition : systematic review and meta-analysis", PLoS One, 9, pp.e89944~ (2014)
  4. Kidger J, "Adolescent selfharm and suicidal thoughts in the ALSPAC cohort : a self-report survey in England", BMC Psychiatry, 12, pp.69~ (2012)
  5. Insel BJ, "Impact of modeling on adolescent suicidal behavior", Psychiatr Clin North Am, 31, pp.293~316 (2008)
  6. Jarvi S, "The impact of social contagion on non-suicidal self-injury : a review of the literature", Arch Suicide Res, 17, pp.1~19 (2013)
  7. Zhu L, "Frequency of exposure to and engagement in nonsuicidal self-injury among inpatient adolescents", Arch Suicide Res, 20, pp.580~590 (2016)
  8. Publications and Reports of the Surgeon General. 2012 national strategy for suicide prevention: goals and objectives for action. A Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention, "Office of the Surgeon General, National Action Alliance for Suicide Prevention", US Department of Health & Human Services, ~ (2012)
  9. Cutler GJ, "Emergency department visits for self-inflicted injuries in adolescents", Pediatrics, 136, pp.28~34 (2015)
  10. Gilbody S, "The early repetition of deliberate self harm", J R Coll Physicians Lond, 31, pp.171~172 (1997)
  11. Gunnell D, "Do patients who self-harm consult their general practitioner soon after hospital discharge? A cohort study", Soc Psychiatry Psychiatr Epidemiol, 37, pp.599~602 (2002)
  12. Zahl DL, "Repetition of deliberate self-harm and subsequent suicide risk : long-term follow-up study of 11, 583 patients", Br J Psychiatry, 185, pp.70~75 (2004)
  13. Sinclair JM, "Healthcare and social services resource use and costs of self-harm patients", Soc Psychiatry Psychiatr Epidemiol, 46, pp.263~271 (2011)
  14. Larkin C, "Risk factors for repetition of selfharm : a systematic review of prospective hospital-based studies", PLoS One, 9, pp.e84282~ (2014)
  15. Kwok CL, "Non-fatal repetition of self-harm in Taipei City, Taiwan : cohort study", Br J Psychiatry, 204, pp.376~382 (2014)
  16. Kapur N, "Non-suicidal selfinjury v. attempted suicide: new diagnosis or false dichotomy?", Br J Psychiatry, 202, pp.326~328 (2013)
  17. Gillies D, "Prevalence and characteristics of self-harm in adolescents : meta-analyses of community-based studies 1990-2015", J Am Acad Child Adolesc Psychiatry, 57, pp.733~741 (2018)
  18. Study on the development of an intervention model for high-risk youth: suicide and self-injury (Korean), "Seo M", Korea Youth Counseling & Welfare Institute (Ministry of Gender Equality and Family), ~ (2018)
  19. "Self-harm and suicide contents cleaning activity (Korean)"[URL]
  20. Brown RC, "#cutting : non-suicidal self-injury(NSSI)on instagram", Psychol Med, 48, pp.337~346 (2018)
  21. Daine K, "The power of the web : a systematic review of studies of the influence of the internet on self-harm and suicide in young people", PLoS One, 8, pp.e77555~ (2013)
  22. Arendt F, "Effects of exposure to self-harm on social media : evidence from a two-wave panel study among young adults", New Media Soc, 21, pp.2422~2442 (2019)
  23. Carroll R, "Self-cutting and risk of subsequent suicide", J Affect Disord, 192, pp.8~10 (2016)
  24. Cully G, "Method of self-harm and risk of self-harm repetition : findings from a national self-harm registry", J Affect Disord, 246, pp.843~850 (2019)
  25. Owens D, "Outcome of deliberate selfpoisoning. An examination of risk factors for repetition", Br J Psychiatry, 165, pp.797~801 (1994)
  26. Tejedor MC, "Attempted suicide : repetition and survival--findings of a follow-up study", Acta Psychiatr Scand, 100, pp.205~211 (1999)
  27. Griffin E, "Increasing rates of self-harm among children, adolescents and young adults : a 10-year national registry study 2007-2016", Soc Psychiatry Psychiatr Epidemiol, 53, pp.663~671 (2018)
  28. Leon SL, "Family factors and repeat pediatric emergency department visits for mental health : A Retrospective Cohort Study", J Can Acad Child Adolesc Psychiatry, 28, pp.9~20 (2019)
  29. Hawton K, "Repetition of self-harm and suicide following self-harm in children and adolescents : findings from the Multicentre Study of Selfharm in England", J Child Psychol Psychiatry, 53, pp.1212~1219 (2012)
  30. Hufford MR, "Alcohol and suicidal behavior", Clin Psychol Rev, 21, pp.797~811 (2001)
  31. Hasking P, "Differentiating non-suicidal self-injury and risky drinking : a role for outcome expectancies and self-efficacy beliefs", Prev Sci, 18, pp.694~703 (2017)
  32. Lockwood J, "Impulsivity and selfharm in adolescence : a systematic review", Eur Child Adolesc Psychiatry, 26, pp.387~402 (2017)
  33. Lee D, "Youth suicide in Korea across the educational stages", Crisis, 41, pp.187~195 (2020)

관련 논문AI추천

응급실을 방문한 자살시도 청소년 임상적 특성의 남녀 차이권재현, 김민정, 김옥준, 김진아, 백소현, 안영주대한소아응급의학회 · 대한소아응급의학회지2020 · 제7권 제2호Injury patterns and characteristics in pediatric emergency department visits in Korea: focusing on self-harm, suicide, violence, and assault김지연, 남동현, 박은화, 양미연, 이명화대한소아응급의학회 · 대한소아응급의학회지2026 · 제13권 제1호지난 10년간 응급실로 내원한 자해/자살 시도자의 양상 및 주요 수단으로서의 중독질환 변화 추이 분석(2011–2020)김수진, 박지환, 배규현, 송제준, 송주현, 이성우, 이시진, 한갑수대한임상독성학회 · 대한임상독성학회지2023 · 제21권 제2호청소년 자살 재시도자의 특성에 관한 연구 -응급실 방문 환자를 중심으로-김무현, 이정미사단법인 한국응급구조학회 · 한국응급구조학회지2024 · 제28권 제3호코로나바이러스감염증-19 범유행 기간의 소아정신과적 응급의 변화곽중일, 류정민, 박준성, 이정용, 이종승, 최승준대한소아응급의학회 · 대한소아응급의학회지2022 · 제9권 제1호Factors predicting meaningful suicide attempts: multiple attempts and index methods구청모, 권혜은, 김문규, 김형진, 배고은, 윤서희, 은소현, 정현수대한소아응급의학회 · 대한소아응급의학회지2023 · 제10권 제1호

이 간행물의 다른 논문 (10건)