Gender differences in characteristics of adolescents with suicide attempt at the emergency department

Purpose: This study was performed to investigate the gender differences in suicide attempts in adolescents. Methods: We reviewed the medical records of adolescents (≤ 18 years) who had visited a university hospital emergency department (ED) for suicide attempts from January 2018 through December 2019. General characteristics of the adolescents, details of the attempt, and outcomes were analyzed. The characteristics were age, gender, the Korean Triage and Acuity Scale, previous attempts, and psychiatric history. The details were initial Glasgow Coma Scale, attempt-arrival time, living alone, method, place, and motivation of the attempt, and concurrent use of alcohol. The outcomes included psychiatric consultation, ED length of stay, and ED outcomes. Results: A total of 86 adolescents were included. Their age ranged from 13 to 18 years, and girls accounted for 65.1%. The girls had more frequent psychiatric history than boys (66.1% vs. 30.0%; P = 0.001) without a significant difference in previous attempts (55.4% vs. 46.7%; P = 0.442). The most common methods of the attempt in the girls and boys were poisoning and sharp objects (53.3% [16 of the 30 boys] vs. 60.7% [34 of the 56 girls]; P = 0.002), respectively. No differences were found in the other details of the attempt and in the rate of psychiatric consultation. The girls had a longer ED length of stay (247.0 minutes vs. 186.5; P = 0.033), a lower rate of discharge against medical advice, and higher rates of hospitalization (discharge against medical advice, 53.6% vs. 76.7%; non-psychiatric, 23.2% vs. 3.3%; psychiatric, 12.5% vs. 0%; P = 0.003). Conclusion: Girls may make suicide attempts, usually by poisoning, and undergo relevant hospitalization, more often than boys. In contrast, boys usually use sharp objects, with a higher rate of discharge against medical advice and lower rates of the attempt and hospitalization.