Suicide Attempts and Adolescents: The Need for Specialized Resources at Adult Trauma Centers

IF 0.4 Q4 PEDIATRICS Adolescent Psychiatry Pub Date : 2020-07-27 DOI:10.2174/2210676610999200727095605
S. Soelling, D. Koganti, I. Padilla, M. Goodman, P. Prakash, Randi N. Smith
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Abstract

Suicide is the second leading cause of adolescent death and suicide attempts outnumber deaths 50:1 for adolescents 15 to 19 years of age. This study examines differences in outcomes between adolescents and adults treated at an adult trauma center in an effort to guide recovery and prevention strategies following an adolescent suicide attempt. Retrospective review of patients aged ≥14 years treated at an urban, Level 1 trauma center for self-inflicted injuries between 2009 and 2018 was performed. The cohort was divided into adolescents (14-19 years) and adults (≥20 years) and into group A (economically distressed) and group B (non-distressed). Demographics, injury, outcomes, and geospatial analysis were compared. Among 723 patients, 60 (8%) were adolescents of which 92% were male, 55% black, 47% blunt injuries, and 53% penetrating. In adults, 76% were male, 41% black, 28% blunt injuries, and 72% penetrating. Mortality estimates for adolescents and adults were 35% and 24%, respectively (p=0.09). Most adolescent deaths occurred within 3 days after admission, while adult deaths occurred further into hospitalization (p<0.01). Cox regression analysis found higher mortality with self-pay compared to private insurance (HR 2.6; p<0.001), and penetrating vs. blunt/other injuries (HR 2.4; p<0.001). Psychiatric care was administered in 64% of adolescents (n=39) and 84% of adults (p< 0.01). Inpatient psychiatric care for adolescents who attempted suicide was limited at an adult trauma center. The high incidence of suicide attempts and community-level distress in adolescents require immediate attention and resources.
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自杀企图与青少年:成人创伤中心对专业资源的需求
自杀是青少年死亡的第二大原因,在15至19岁的青少年中,自杀未遂的人数超过死亡人数的50:1。本研究考察了在成人创伤中心接受治疗的青少年和成年人之间的结果差异,以指导青少年自杀未遂后的康复和预防策略。回顾性分析了2009年至2018年期间在城市一级创伤中心治疗的≥14岁的自我伤害患者。将队列分为青少年(14-19岁)和成人(≥20岁),分为A组(经济困难组)和B组(无经济困难组)。比较了人口统计学、损伤、结局和地理空间分析。723例患者中,60例(8%)为青少年,其中92%为男性,55%为黑人,47%为钝伤,53%为穿透伤。在成年人中,76%是男性,41%是黑人,28%是钝器伤,72%是穿透伤。青少年和成人的死亡率估计分别为35%和24% (p=0.09)。大多数青少年死亡发生在入院后3天内,而成人死亡发生在住院后(p<0.01)。Cox回归分析发现,与私人保险相比,自费保险的死亡率更高(HR 2.6;p<0.001),穿透伤vs钝器/其他损伤(HR 2.4;p < 0.001)。64%的青少年(n=39)和84%的成人(p< 0.01)接受了精神科护理。在成人创伤中心,对企图自杀的青少年的住院精神病治疗是有限的。自杀未遂的高发生率和社区层面的困扰青少年需要立即得到关注和资源。
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来源期刊
Adolescent Psychiatry
Adolescent Psychiatry PEDIATRICS-
CiteScore
0.80
自引率
0.00%
发文量
20
期刊介绍: Adolescent Psychiatry a peer-reviewed journal, aims to provide mental health professionals who work with adolescents with current information relevant to the diagnosis and treatment of psychiatric disorders in adolescents. Adolescent Psychiatry reports of original research, critical reviews of topics relevant to practitioners, clinical observations with analysis and discussion, analysis of philosophical, ethical or social aspects of the fields of psychiatry and mental health, case reports with discussions, letters, and position papers. Topics include adolescent development and developmental psychopathology, psychotherapy and other psychosocial treatment approaches, psychopharmacology, and service settings and programs. The primary focus of the work should be on adolescents, transition-aged youth, The primary focus of the work should be on adolescents, transition-aged youth, or emerging adults, that is, persons 12-24 years of age . Articles on families of adolescents, or adults who have been followed since adolescence will also be considered.
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