Evaluation of the association between bilateral calcaneal fractures and suicide attempts: Findings from 4 different trauma centers in Turkey

Emre Gültaç, A. Açan, C. Kilinç, N. Gündüz, N. D. Demirkıran, Mehmet Yücens, N. Aydogan
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Abstract

Background: We aimed to to determine the association between bilateral calcaneal fractures and suicide attempt and some socio-demographic characteristics. Methods: This study was conducted among patients admitted to the emergency departments of four trauma centers with bilateral calcaneal fractures between January 2014 and March 2017. The Sociodemographic Data Form, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) and Axis I Disorders (SCID-I) were applied to participants. Comparisons about age and gender was made between suicidal and non-suicidal patiens with bilateral calcaneal fractures. Results: Twenty-three patients with bilateral calcaneus fractures were included in the study. Of the 23 patients with bilateral calcaneal fractures, 14 (61%) were evaluated as suicidal and 9 (39%) were evaluated as not suicidal. The majority of suicidal jumpers were female (n = 11, 78.6%). Suicidal patients were younger compared with non-suicidal fallers. As a result of SCID I interview, 9 (64.3%) of 14 suicidal jumpers were diagnosed with serious psychiatric diagnoses: One patient was diagnosed with first episode psychotic disorder, one with schizophrenia, one with Schizoaffective Disorder, one with Bipolar Disorder, two with Major Depressive Disorder and three with Adjustment Disorder. Conclusion: Based on our study results we determined that suicidal jumpers are frequently diagnosed with serious psychiatric disorders. Therefore, the psychiatric dimension should be taken into consideration in the treatment plan for patients with bilateral calcaneal fractures and the multidisciplinary approach should be taken.
评估双侧跟骨骨折与自杀企图之间的关系:来自土耳其4个不同创伤中心的发现
背景:我们的目的是确定双侧跟骨骨折与自杀企图和一些社会人口统计学特征之间的关系。方法:选取2014年1月至2017年3月在四家创伤中心急诊科收治的双侧跟骨骨折患者为研究对象。应用社会人口学数据表、精神障碍诊断与统计手册第四版(DSM-IV)结构化临床访谈和I轴障碍(SCID-I)对参与者进行调查。比较自杀性和非自杀性双侧跟骨骨折患者的年龄和性别。结果:23例双侧跟骨骨折纳入研究。23例双侧跟骨骨折患者中,14例(61%)有自杀倾向,9例(39%)无自杀倾向。跳楼自杀者以女性居多(n = 11, 78.6%)。有自杀倾向的患者比没有自杀倾向的患者更年轻。通过SCID I访谈,14例自杀跳崖者中有9例(64.3%)被诊断为严重精神疾病:1例诊断为首发精神障碍,1例诊断为精神分裂症,1例诊断为分裂情感障碍,1例诊断为双相情感障碍,2例诊断为重度抑郁症,3例诊断为适应障碍。结论:根据我们的研究结果,我们确定自杀跳楼者经常被诊断患有严重的精神疾病。因此,在双侧跟骨骨折患者的治疗方案中应考虑精神病学维度,采取多学科联合治疗。
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