Abstract

Objective

A suicide attempt is the most potent predictor of future suicidal behavior, yet little is known about how to manage and respond to reports of attempt histories in hospitalized medical patients. This study aims to describe the prevalence and characteristics of pediatric and adult medical inpatients who report a past suicide attempt.

Method

Participants were medical inpatients, aged 10–93 years, enrolled in two suicide risk screening instrument validation studies. Participants completed the Ask Suicide-Screening Questions (ASQ) and the Patient Health Questionnaire (PHQ).

Results

A total of 1324 medical inpatients (624 pediatric, 700 adult) completed the ASQ, with 114 participants (8.6%) reporting a past suicide attempt (51 pediatric; 63 adults). Comparing youth to adults, there was no significant difference between attempt rates (χ²=0.29, p = 0.59). Youth with a past attempt were significantly more likely to report past week suicidal ideation (OR = 28.22; 95% CI = 5.90, 135.06) and have a history of mental health care (OR = 9.11; 95% CI = 2.59–32.10), compared to those without a past attempt. Adults with a past attempt were significantly more likely to screen positive for depression, compared to those without attempt histories (OR = 5.00; 95% CI = 2.31–10.83).

Conclusions

Nearly 9% of hospitalized medical patients endorsed a past suicide attempt when screened. Since adolescence is a critical time for detecting suicide risk, screening that includes past suicidal behavior may be an important means to identify youth with recent suicidal thoughts. By assessing recency of suicide attempts in adults, medical settings may optimize the effectiveness of how positive suicide risk screens are managed.

• HIGHLIGHTS

• Roughly 9% of medical patients reported a past suicide attempt when screened.

• Adolescence is a critical time for detecting suicide risk and intervening.

• Assessing past suicide attempts in adults can help with managing positive screens.

中文翻译：

---

儿科和成人住院患者自杀未遂史的比较及筛查意义

摘要

客观的

自杀未遂是未来自杀行为的最有效预测指标，但对于如何管理和应对住院内科患者的尝试历史报告却知之甚少。本研究旨在描述报告过去自杀未遂的儿科和成人内科住院患者的患病率和特征。

方法

参与者是年龄在 10-93 岁之间的内科住院患者，他们参加了两项自杀风险筛查工具验证研究。参与者完成了询问自杀筛查问题 (ASQ) 和患者健康问卷 (PHQ)。

结果

共有 1324 名内科住院患者（624 名儿童，700 名成人）完成了 ASQ，其中 114 名参与者（8.6%）报告了过去的自杀企图（51 名儿童；63 名成人）。将青少年与成人进行比较，尝试率之间没有显着差异（χ ² =0.29，p  = 0.59）。过去尝试过的青少年更有可能报告过去一周的自杀意念（OR = 28.22；95% CI = 5.90, 135.06）并且有精神保健史（OR = 9.11；95% CI = 2.59-32.10），与那些没有过去尝试的人相比。与没有尝试过的成年人相比，过去尝试过抑郁症的成年人更有可能筛查出抑郁症阳性（OR = 5.00；95% CI = 2.31-10.83）。

结论

近 9% 的住院内科患者在接受筛查时支持过去的自杀企图。由于青春期是检测自杀风险的关键时期，因此包括过去自杀行为的筛查可能是识别最近有自杀念头的年轻人的重要手段。通过评估成人自杀未遂的新近程度，医疗机构可​​以优化积极的自杀风险筛查管理的有效性。

• 强调

• 大约 9% 的内科患者在接受筛查时报告了过去的自杀企图。

• 青春期是检测自杀风险和干预的关键时期。

• 评估成年人过去的自杀企图有助于管理积极的筛查。