Characterization of the suicide cases admitted to an emergency service in Turkey

Suicide attempts are multifaceted actions originating from a wide variety of socio-demographic and clinical factors. This study aimed to characterize suicide cases presented to the emergency service of a University Hospital in Turkey. This retrospective cross-sectional study was conducted by evaluating patients admitted to the emergency service. Descriptive statistics, Chi-square, and the Student’s t-test were used to compare groups. A total of 507 patients were admitted to the emergency department with a suicide attempt. Among the applicants, 383 (75.5%) were due to drug poisoning, 79 (15.6%) due to self-laceration, and 45 (8.9%) due to other reasons. Among the patients with drug self-poisoning, the most frequent intoxication was with multiple medications. Most of the patients were females, aged 26-44 years, single, unemployed, living with their family, attempted at home in weekdays, and accompanied by a family member in the emergency unit. Of the patients, 74 (14.6%) had a history of at least one previous suicide attempt. The total number of discharged patients was 438 (86.3%), while the remaining 69 (13.7%) were hospitalized, of whom 39 (56.5%) were males (p=0.004). The majority of hospitalized patients were in the 17-44-age interval. There was a significant difference between hospitalized and discharged patients concerning age groups (p=0.007). Also, a positive family history of a psychiatric disease was associated with the proportions of hospitalization (positive history: 14 (28.0%) hospitalizations vs. negative history: 55 (12.0%) hospitalizations) (p=0.002). Logistic regression analysis demonstrated that suicide attempts with drugs was significantly associated with gender and accompanying alcohol use (p

PDF

___

1. Organization WH. Meeting report: WHO technical consultation: nutritionrelated health products and the World Health Organization model list of essential medicines–practical considerations and feasibility: Geneva, Switzerland, 20–21 September 2018. WHO. 2019.

2. Hawton K, Saunders KEA, O’Connor RC. Self-harm and suicide in adolescents. Lancet. 2012;379:2373–82.

3. Nock MK, Borges G, Bromet EJ, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192:98–105.

4. Spittal MJ, Pirkis J, Miller M, Studdert DM. Declines in the lethality of suicide attempts explain the decline in suicide deaths in Australia. PLoS One. 2012;7:e44565.

5. Canner JK, Giuliano K, Selvarajah S, Hammond ER, Schneider EB. Emergency department visits for attempted suicide and self harm in the USA: 2006–2013. Epidemiol Psychiatr Sci. 2018;27:94–102.

6. Lee CA, Choi SC, Jung KY, et al. Characteristics of patients who visit the emergency department with self-inflicted injury. J Korean Med Sci. 2012;27:307–12.

7. Baraff LJ, Janowicz N, Asarnow JR. Survey of California emergency departments about practices for management of suicidal patients and resources available for their care. Ann Emerg Med. 2006;48:452–8.

8. Keskin Gokcelli D, Tosun Tasar P, Akcam NO, et al. Evaluation of attempted older adults suicides admitted to a University Hospital Emergency Department: Izmir study. Asian J Psychiatr. 2017;30:196-9.

9. Von Elm E, Altman DG, Egger M, et al. The Strengthening the reporting of observational studies in epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495–9.

10. El Majzoub I, El Khuri C, Hajjar K, et al. Characteristics of patients presenting post-suicide attempt to an Academic Medical Center Emergency Department in Lebanon. Ann Gen Psychiatry. 2018;17:21.

11. Filippatos G, Karasi E. Characteristics of attempted suicide patients presenting to a greek emergency department. Heal Sci J. 2017;11:1.

12. Turhan E, Inandi T, Aslan M, et al. Epidemiology of attempted suicide in Hatay, Turkey. Neurosci. 2011;16:347-52.

13. Vos T, Abajobir AA, Abbafati C, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017.

14. Kvaran RB, Gunnarsdottir OS, Kristbjornsdottir A, et al. Number of visits to the emergency department and risk of suicide: a population-based case– control study. BMC Public Health. 2015;15:227.

15. Ting SA, Sullivan AF, Boudreaux, et al. Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993–2008. Gen Hosp Psychiatry. 2012;34:557–65.

16. Mowry JB, Spyker DA, Cantilena Jr LR, et al. 2013 Annual report of the American association of poison control centers’ National poison data system (NPDS): 31st annual report. Clin Toxicol. 2014;52:1032–283.

17. Kawashima Y, Yonemoto N, Inagaki M, et al. Prevalence of suicide attempters in emergency departments in Japan: a systematic review and meta-analysis. J Affect Disord. 2014;163:33–9.

18. Ronquillo L, Minassian A, Vilke GM, et al. Literature-based recommendations for suicide assessment in the emergency department: a review. J Emerg Med. 2012;43:836-42.

19. Fairweather-Schmidt AK, Anstey KJ, Salim A, et al. Baseline factors predictive of serious suicidality at follow-up: findings focussing on age and gender from a community-based study. BMC Psychiatry. 2010;10:41

20. Stuckler D, Basu S, Suhrcke M, et al. The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet. 2009;374:315-23.

21. Qin P, Agerbo E, Mortensen PB. Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case-control study based on longitudinal registers. Lancet. 2002;360:1126–30.

22. Burón P, Jimenez-Trevino L, Saiz PA, et al. Reasons for attempted suicide in Europe: prevalence, associated factors, and risk of repetition. Arch Suicide Res. 2016;20:45–58.

23. Joubert L, Petrakis M, Cementon E. Suicide attempt presentations at the emergency department: outcomes from a pilot study examining precipitating factors in deliberate self-harm and issues in primary care physician management. Soc Work Health Care. 2012;51:66-76.

24. Betz ME, Boudreaux ED. Managing suicidal patients in the emergency department. Ann Emerg Med. 2016;67:276.

25. Larkin C, Di Blasi Z, Arensman E. Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies. PLoS One. 2014;9:e84282.

26. Callanan VJ, Davis MS. Gender differences in suicide methods. Soc Psychiatry Psychiatr Epidemiol. 2012;47:857-69.

27. Conwell Y, Duberstein PR, Caine ED. Risk factors for suicide in later life. Biol Psychiatry. 2002;52:193–204.

28. Duberstein PR, Conwell Y, Conner KR, et al. Poor social integration and suicide: fact or artifact? A case-control study. Psychol Med. 2004;34:1331.

29. Simon RI. Assessing and managing suicide risk: Guidelines for clinically based risk management. American Psychiatric Pub. 2008.

30. Office of the Surgeon General (US); National action alliance for suicide prevention (us). 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 . Washington (DC), USA: US Department of Health & Human Services (US); 2012.

31. World Health Organization. Preventing suicide: A resource for primary health care workers. Geneva, Switzerland: WHO. 2000.