Trends in emergency health care due to suicidal behaviour in youth and adult populations

IF 2.5 4区 医学 Q2 PSYCHIATRY
Sofía Abascal-Peiró , Alejandro Porras-Segovia , Blanca Margarit-Parrondo , Enrique Baca-García
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Abstract

Background and Objectives

Since the outbreak of the COVID-19 pandemic, there has been a significant increase in mental health-related ED visits, especially in child and adolescent population. This study aims to analyze trends in emergency care for mental health, including suicidal behaviour, in adolescents over seven years, and compare them with adults.

Methods

This observational and retrospective study included 33,376 visits, involving 12,159 individuals, to the ED for mental health issues between 2015 and 2021 from two hospitals in Madrid (Hospital Fundación Jiménez Díaz and Hospital Rey Juan Carlos). Sociodemographic and clinical data were collected from electronic health records. Logistic regression models were used to identify factors associated with presentations for suicidal behavior, with odds ratios (OR) and 95 % confidence intervals (95 %CI).

Results

In adults, presenting to the emergency department for suicidal behaviour was significantly associated with family history of suicide (OR=1.497, 95 %CI [1.250–1.794]), higher number of previous suicide attempts (OR=1.376, 95 %CI [1.331–1.422]), and substance intoxication (OR=1.317, 95 %CI [1.132–1.533. In children and adolescents, previous suicide attempts (OR=1.803, 95 %CI [1.485–2.189]), being female (OR=1.848, 95 %CI [1.281–2.666]) and older age (OR=1.113, 95 %CI [1.015–1.222]) were associated with higher odds of presenting for suicidal behaviour. Neurodevelopmental disorders were also significantly associated with increased odds of presenting for suicidal behaviour (OR=5.328, 95 %CI [2.353–12.063]), while psychotic disorders (OR=0.133, 95 %CI [0.032–0.548]) and anxiety disorders (OR=0.282, 95 %CI [0.128–0.622]) were linked to lower odds. In contrast to adults, the percentage of ED visits for suicidal behaviour in children and adolescents increased steadily over the study period, peaking at 30.3 % in 2020

Conclusion

These findings underscore the need for age- and gender-specific approaches in the management and prevention of suicidal crises in mental health emergency settings, with special attention to past suicidal behavior and family history as critical risk factors.
青年和成人自杀行为导致的紧急保健趋势
背景与目的自2019冠状病毒病(COVID-19)大流行爆发以来,与心理健康相关的急诊科就诊人数显著增加,尤其是儿童和青少年。本研究旨在分析七岁以上青少年心理健康紧急护理的趋势,包括自杀行为,并将其与成年人进行比较。方法:这项观察性和回顾性研究包括2015年至2021年间马德里两家医院(Fundación jim涅斯Díaz医院和Rey Juan Carlos医院)的33,376次就诊,涉及12,159人。从电子健康记录中收集社会人口学和临床数据。采用Logistic回归模型,以比值比(OR)和95%可信区间(95% CI)确定与自杀行为表现相关的因素。结果在成年人中,因自杀行为到急诊室就诊与自杀家族史(OR=1.497, 95% CI[1.250 ~ 1.794])、较高的自杀企图次数(OR=1.376, 95% CI[1.331 ~ 1.422])和物质中毒(OR=1.317, 95% CI[1.132 ~ 1.533])显著相关。在儿童和青少年中,既往自杀企图(OR=1.803, 95% CI[1.485-2.189])、女性(OR=1.848, 95% CI[1.281-2.666])和年龄较大(OR=1.113, 95% CI[1.015-1.222])与出现自杀行为的几率较高相关。神经发育障碍也与出现自杀行为的几率增加显著相关(OR=5.328, 95% CI[2.353-12.063]),而精神障碍(OR=0.133, 95% CI[0.032-0.548])和焦虑症(OR=0.282, 95% CI[0.128-0.622])的几率较低。与成人相比,在研究期间,儿童和青少年因自杀行为就诊的比例稳步上升,在2020年达到30.3%的峰值。这些发现强调了在精神卫生紧急环境中,管理和预防自杀危机需要针对年龄和性别的方法,特别注意过去的自杀行为和家族史是关键的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
40
审稿时长
43 days
期刊介绍: The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.
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