Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

Emergency Department Admission and Mortality Rate for Suicidal Behavior

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 406-414 ◽  
Author(s):  
Raimondo Maria Pavarin ◽  
Angelo Fioritti ◽  
Francesca Fontana ◽  
Silvia Marani ◽  
Alessandra Paparelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Metropolitan Area ◽  
Suicidal Behavior ◽  
Mortality Risk ◽  
Illicit Drugs ◽  
Attempted Suicide ◽  
Cox Model ◽  
Emergency Department Admission ◽  
Completed Suicide

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

Risk of suicide after attempted suicide in the population of Slovenia from 1970 to 1996

2006 ◽  
Vol 21 (6) ◽  
pp. 396-400 ◽  
Author(s):  
Slavko Ziherl ◽  
Bojan Zalar
Keyword(s):  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Categorical Variables ◽  
Frequency Table ◽  
Completed Suicide ◽  
The Republic ◽  
And Gender ◽  
Log Linear ◽  
Commit Suicide

AbstractObjective:All suicide attempts cannot predict suicide, therefore we examined those characteristics of suicide attempt which could most accurately predict completed suicide.Subject and methods:Subjects were all individuals registered as committed suicides (N = 16,522) or attempted suicides (N = 15,057) in the register of suicides of the Republic of Slovenia between 1970 and 1996. Log linear analysis of a frequency table was used to uncover relationship between categorical variables.Results:The model we found fit between variables: mode, number of repetitions and type, then between number of repetitions, type and gender, and between mode, type and gender.Discussion:The risk of suicide in those who previously attempted suicide is approximately 773 times higher than the risk of suicide without a previous suicide attempt. Those who attempt suicide by hanging (hanging being in Slovenia the most frequent mode of completed suicide) are at even greater risk to commit suicide.Conclusion:Our data suggests that clinicians should heighten their awareness that any suicide attempt can in some 20% predict suicide. Someone who has attempted suicide by hanging is at the highest risk of suicide.

scholarly journals Profil Kegawatdaruratan Pasien Berdasarkan Start Triage Scale di Instalasi Gawat Darurat RSUP Prof. Dr. R. D. Kandou Manado Periode Januari 2018 sampai Juli 2018

e-CliniC ◽  
2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Muhammad F. Bazmul ◽  
Eka Y. Lantang ◽  
Barry I. Kambey
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Emergency Services ◽  
Descriptive Study ◽  
Emergency Case ◽  
Number Of Patients ◽  
Life Threatening

Abstract: Emergency Department provides first emergency services to patients with threats of death and disability in an integrated manner involving multi disciplines. Patients who come to the Emergency Department are always assessed as 3 priorities, namely priorities 1, 2 and 3. Priority 1 is case/disease with life-threatening emergency or severe emergency; Priority 2 is case/disease with mild emergency; and Priority 3 is non-emergency case/disease. This study was aimed to obtain the Triage profile of patients at Emergency Department of Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using patients’ medical records. Samples were all patients treated at the Emergency Department of Prof. Dr. R. D. Kandou Hospital from January 2018 until July 2018. The results showed that there were 19,229 patients as samples. Based on sex, most patients were male, meanwhile based on age most were 51-70 years, with the highest number of patients in March 2018. There were 6,913 patients (35.9%) in the orange or emergency category (Priority 2) and 6,130 patients (31.8%) in the yellow category (Priority 3). Conclusion: Based on the Start Triage in Emergency Department, the majority of patients were in Priority 2 category, followed by Priority 3 category.Keywords: Emergency Department, Start Triage Abstrak: Instalasi Gawat Darurat (IGD) memberikan pelayanan pertama yang bersifat emergency pada pasien dengan ancaman kematian dan kecacatan secara terpadu dengan melibatkan multi disiplin ilmu. Pasien yang datang di IGD selalu dinilai kegawatannya menja-di 3 prioritas, yaitu prioritas 1, 2, dan 3. Prioritas 1 yaitu kasus/penyakit dengan kegawat-daruratan yang mengancam jiwa atau gawat darurat berat. Prioritas 2 untuk kasus/penyakit dengan gawat darurat ringan. Prioritas 3 untuk kasus/penyakit yang bukan gawat darurat. Penelitian ini bertujuan untuk mengetahui profil skala Triase pasien yang masuk di IGD RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif-retrospektif, menggunakan data rekam medis pasien. Sampel penelitian ialah seluruh pasien yang dirawat di IGD RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2018 sampai Juli 2018. Hasil penelitian mendapatkan data pasien yang masuk ke Ruang IGD RSUP Prof. Dr. R. D. Kandou Manado terhitung sejak Januari hingga Juli 2018 sebanyak 19.229 orang. Distribusi pasien terbanyak berdasarkan jenis kelamin ialah laki-laki, dan berdasarkan usia ialah 51-70 tahun, dengan jumlah pasien terbanyak pada bulan Maret 2018. Pasien IGD terbanyak ialah kategori jingga yaitu emergency (Prioritas 2) berjumlah 6.913 orang (35,9%) serta kategori kuning (Prioritas 3) berjumlah 6.130 orang (31,8%). Simpulan: Berdasarkan skala Triase di IGD, pasien terbanyak ialah Prioritas 2, disusul dengan Prioritas 3.Kata kunci : Instalasi Gawat Darurat, skala Triase

scholarly journals S210. COMPARATIVE EFFECTIVENESS OF ANTIPSYCHOTICS FOR RISK OF ATTEMPTED OR COMPLETED SUICIDE AMONG PERSONS WITH SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S118-S119
Author(s):  
Heidi Taipale ◽  
Markku Lähteenvuo ◽  
Antti Tanskanen ◽  
Ellenor Mittendorfer-Rutz ◽  
Jari Tiihonen
Keyword(s):  
Drug Use ◽  
Comparative Effectiveness ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Antipsychotic Therapy ◽  
Completed Suicide ◽  
Hazard Ratios ◽  
Persons With Schizophrenia ◽  
Swedish Cohort

Abstract Background Suicidal attempts and suicide are rather common phenomena in persons with schizophrenia whom are 6–14 times more likely to die due to suicide than the general population. Very little is known on effectiveness of antipsychotics in preventing suicide attempts and completed suicides among patients with schizophrenia. Whether all antipsychotics are effective in preventing attempted or completed suicides also remains unclear. The objective of our study was to investigate comparative effectiveness of antipsychotics for risk of attempted or completed suicide among all patients with schizophrenia in Finland and Sweden. Methods Two nationwide register-based cohort studies were conducted including all individuals with schizophrenia in Finland (N=61889) and Sweden (N=29823). The Finnish cohort included all persons treated for schizophrenia in inpatient care (1972–2014), with follow-up for drug use and outcomes during 1996–2017. The Swedish cohort included all persons with treatment contact due to schizophrenia in inpatient or specialized outpatient care, sickness absence, or disability pension (2006–2013), with follow-up for drug use and outcomes during 2006–2016. The main exposure included the ten most commonly used antipsychotic monotherapies, and also adjunctive pharmacotherapies (antidepressants, mood stabilizers, lithium, benzodiazepines and related drugs were investigated). The main outcome measure was attempted or completed suicide which was analyzed with within-individual models by comparing use and non-use periods in the same individual. Sensitivity analyses were conducted by between-individual models, with attempted suicide (hospitalization only) as an outcome, and by censoring first 30 days from each exposure. Results are reported as hazard ratios (HRs) with 95 % confidence intervals (95% CI). Results Compared with no use of antipsychotics, clozapine was the only antipsychotic therapy consistently associated with a decreased risk of suicidal outcomes. Hazard ratios (HRs) and 95% CI for attempted or completed suicide were 0.64 (95% CI 0.49–0.84) in the Finnish cohort, and 0.66 (0.43–0.99) in the Swedish cohort, and for attempted suicide 0.60 (0.46–0.79) in the Finnish cohort and 0.62 (0.40–0.95) in the Swedish cohort. No other antipsychotic was associated with a reduced risk of attempted and/or completed suicide than clozapine. Regarding adjunctive pharmacotherapies, benzodiazepines and Z-drugs were associated with an increased risk of suicide attempts or deaths (HRs for benzodiazepines 1.29–1.30 and 1.33–1.62 for Z-drugs, not reaching statistical significance in the Swedish cohort). Discussion The results from two large nationwide cohorts provide the first evidence on comparative real-world effectiveness of specific antipsychotics in the prevention of severe suicidal behavior. Clozapine was the only pharmacological treatment associated with a substantially decreased risk of attempted or completed suicide and should be considered as a first-line treatment for patients with suicidal ideation or behavior.

Child Abuse and Attempted Suicide

1980 ◽  
Vol 137 (4) ◽  
pp. 319-323 ◽  
Author(s):  
Jacquie Roberts ◽  
Keith Hawton
Keyword(s):  
Child Abuse ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Previous History ◽  
Psychiatric Disturbance ◽  
At Risk Children ◽  
History Of ◽  
Group A ◽  
Marital Breakdown ◽  
The Relationship

SummaryOf a sample of families containing abused and at risk children, in 29 per cent one or both parents had attempted suicide. The rate at which the suicide attempts were repeated within a year was higher than that expected for other attempters of the same age group. A previous history of psychiatric disturbance and marital breakdown was strongly associated with the combination of child abuse and suicidal behaviour. The relationship between child abuse and attempted suicide did not appear in most cases to have been a direct one; often both forms of behaviour seemed to reflect marital difficulties.

scholarly journals Rethinking pathways to completed suicide by female prisoners

2015 ◽  
Vol 10 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Sophie Oakes-Rogers ◽  
Karen Slade
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Interpersonal Trauma ◽  
Small Sample ◽  
Traumatic Experience ◽  
Content Type ◽  
Female Prisoners ◽  
Completed Suicide ◽  
Direct Trauma ◽  
Self Harm

Purpose – The purpose of this paper is to explore the role of trauma experience in pathways to self-harm or attempted suicide in female prisoners who died through self-inflicted death in England and Wales. Design/methodology/approach – Quantitative study using the Prison and Probation Ombudsmen’s independent reports on deaths in custody. In total, 32 cases of female self-inflicted death in custody were coded on the presence of direct or interpersonal trauma, presence of superficial self-harm (SSH), near-lethal self-harm (NLSH), suicide attempts and recent significant life event. The number of previous suicide attempts (PSAs) and age at time of death was recorded. Findings – Direct trauma is linked with repeated suicide attempts but recued the likelihood of SSH prior to suicide. Neither interpersonal trauma nor age increased likelihood of pre-suicide behaviours. NLSH was not predicted by either traumatic experience. Amongst these completed suicide cases, 56 per cent were not reported as having experienced trauma, 46 per cent had no recorded PSAs and 12 per cent also had no previous self-harm reported. Research limitations/implications – The small sample limited statistical power and specificity of classifications. Provides support for direct trauma in developing capacity for repeated suicidal behaviour as indicated in theoretical models of suicide (Joiner, 2005; O’Connor, 2011). Practical implications – Different pathways to suicide likely to exist for female prisoners and importance of trauma intervention services. Originality/value – Using cases of completed suicide in female prisoners to investigate the pathway to suicide from trauma through previous self-harm and attempted suicide.

scholarly journals Suicidal Career in Severe Depression among Long-Term Survivors: In a Followup after 37–53 Years Suicide Attempts Appeared to End Long before Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa Crona ◽  
Alexander Mossberg ◽  
Louise Brådvik
Keyword(s):  
Suicide Attempt ◽  
Depressive Episode ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Healing Process ◽  
Severe Depression ◽  
Long Term Survivors ◽  
Course Of Depression

Objective. To describe the suicidal career in the long-term course of severe depression.Subjects and Method. Seventy-five former in-patients were interviewed by telephone about course of depression and suicide attempts 37–53 years after index admission. Medical records were read in many cases.Results. 29 subjects had attempted suicide, 13 repeated, 10 made severe, and 13 violent attempts. The risk of suicide attempt decreased by 10% for every decade spent depressed. Suicide attempts were made early in course of depression, and more time was spent depressed after suicide attempts than before.Conclusions. A healing process of the suicidal career, which may occur long before the end of the last depressive episode (sometimes decades), is proposed.

scholarly journals A józsefvárosi „TÁMASZ” Addiktológiai Gondozóban kezelt és 2001–2018-ban elhunyt betegek haláloki adatainak vizsgálata

2019 ◽  
Vol 160 (47) ◽  
pp. 1864-1871
Author(s):  
Miklós Péter Kalapos
Keyword(s):  
Medical Records ◽  
Suicide Attempts ◽  
Female Dominance ◽  
Mortality Data ◽  
Violent Death ◽  
Skilled Workers ◽  
Completed Suicide ◽  
National Rate ◽  
Central Statistical ◽  
Central Statistical Office

Abstract: Introduction: The analysis of the mortality data of patients is important. Aim: Examination of data from patients treated in the Addictological Out-patient Clinic in Józsefváros and deceased between 2001 and 2018. Method: Patients’ data originated from medical records. The national and Budapest data were from the publications of the Hungarian Central Statistical Office. Results: The age of patients was 52.85 ± 11.81 years for women and 51.99 ± 12.47 years for men. Two-thirds, regardless of gender, were alcoholic. There were many violent deaths. A new phenomenon was the high number of drug- and murder-associated deaths. The former group was dominated by men. The latter group showed female dominance. The completed suicide rate was 14.6%. Suicide attempts occurred in 22.4% of patients. The majority of patients were skilled workers. Conclusion: Data support the view that addict patients die earlier. Leading deaths, unlike previous investigations, were violent deaths. The rate of suicide was higher than the national rate, but it was the same as previously reported, indicating a high risk of this population. Gender differences were observed with regard to violent death, requiring further elucidation. Orv Hetil. 2019; 160(47): 1864–1871.

scholarly journals Clinical profile of patients of poisoning admitted in emergency department in a teaching hospital, MAMC, Agroha, Haryana, India

2017 ◽  
Vol 5 (8) ◽  
pp. 3767
Author(s):  
Mohd Y. Shah ◽  
Mohd M. Naqash ◽  
Faisal Y. Shah ◽  
Faizan Y. Shah
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Agricultural Land ◽  
Suicide Attempts ◽  
Family Members ◽  
Clinical Profile ◽  
Precipitating Factors ◽  
Number Of Patients ◽  
Catchment Areas ◽  
History Of

3 Million Serious poisoning (1 million accidentals and 2 million suicide attempts) occur each year worldwide.1 India ranks second in Asia in annual pesticide consumption.2 A study was conducted (1 year) wherein patients with history of poisoning were admitted from different catchment areas of hospital (30 Km radius). The total number of patients admitted during study period was 61. Patients had consumed these agents to attempt suicide. Out of 61 patients 26 were male and rest 37 were females. 18 patients died and rest survived. The precipitating factors in the suicide attempts were stranded relations with husband/wife, failure in examination and confrontation with parents. The availability of these poisonous substances in the household make people to consume these agents on slight provocation.3 All our patients, though majority were literate, were from families who had agricultural land and majority of their family members were farmers. Table 1 and Table 2 depict the characteristics and clinical profile of 61 patients admitted during the study period.

scholarly journals Profile of cases suspected of attempted suicide by exogenous intoxication

2018 ◽  
Vol 9 (2) ◽  
pp. 123
Author(s):  
Fernanda Pamela Machado ◽  
Marcos Hirata Soares ◽  
Patricia Dias Francisquini ◽  
Layla Karina Ferrari Ramos
Keyword(s):  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
University Hospital ◽  
Professional Service ◽  
Information Center ◽  
Life Threatening ◽  
Physical Consequences ◽  
The University ◽  
Present Life

Objective: To characterize the profile of patients suspected of attempting suicide, based on cases reported by the Toxicological Information Center of the University hospital of Southern Brazil.Methods: This is a retrospective aggregate study, based on the analysis of medical records and files between January 2009 and December 2012, aiming to collect information that would create the profile of patients suspected of attempting suicide, from the cases notified by the Toxicological Information Center.Results: Regarding the physical consequences and the danger of the suicide attempt, 97% of the suicide attempts did not present life threatening (n = 1,605); 85.4% were not referred to any professional service (n = 1,412). The year 2012 was the year with the highest number of suicide attempts that the other years.Conclusions: It is considered important to improve the notification form for poisoning injuries, to better detect information about suicide attempts.

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