Recency of Suicide Attempt, Ideation, and Reattempt in the Emergency Department: Managing Youth With a Past Attempt
Abstract
Objective
Methods
Results
Conclusions
HIGHLIGHTS
METHODS
Setting and Participants
![image](/cms/10.1176/appi.prcp.20240006/asset/images/rcp21088-fig-0001.png)
Measures
Past SA
Recent SI
Reattempt within 3 months post‐ED‐discharge
Statistical Analyses
RESULTS
Total sample (reported a past attempt at index ED visit and received a follow‐up, N = 351) | Participants who reattempted suicide within 3 months post‐ED‐discharge (n = 60; 17%) | |
---|---|---|
Age | 15.3 (1.5) | 15.0 (1.6) |
Gender identity | ||
Cisgender male | 71 (20.2) | 6 (11.7) |
Cisgender female | 245 (69.8) | 45 (75.0) |
Transgender/gender‐diverse | 34 (9.7%) | 8 (13.3) |
Unavailable | 1 (0.3%) | ‐ |
Race | ||
White | 206 (58.7) | 39 (65.0) |
Black | 69 (19.6) | 12 (20.0) |
Asian | 1 (0.3) | 1 (1.7) |
AI/AN | 3 (0.8) | ‐ |
NH/PI | 2 (0.6) | 1 (1.7) |
Multiracial | 32 (9.1) | 5 (8.3) |
Unknown/unavailable | 40 (10.8) | 3 (3.3) |
Ethnicity | ||
Hispanic/Latino | 77 (21.9) | 10 (16.7) |
Not Hispanic/Latino | 245 (69.8) | 45 (75.0) |
Unknown/unavailable | 29 (8.3) | 5 (8.3) |
Chief complaint | ||
Medical/other | 165 (47.0) | 14 (23.3) |
Psychiatric | 186 (53.0) | 46 (76.7) |
ED disposition | ||
Psychiatric admission/transferc | 139 (39.6) | 36 (60.0) |
Non‐psychiatric admission | 20 (5.7) | 2 (3.4) |
Discharged | 188 (53.6) | 21 (35.0) |
AMA/other | 4 (1.1) | 1 (1.6) |
Recency of past attempt relative to index ED visit | ||
Within the past week | 103 (28.8) | 31 (51.7) |
1 week to 3 months | 68 (19.0) | 12 (20.0) |
3–6 months | 43 (12.3) | 6 (10.0) |
6 months to 1 year | 41 (11.5) | 6 (10.0) |
Over 1 year ago | 96 (27.4) | 5 (8.3) |
Sole report of past attempt over 1 year ago with no past month SI | 68 (19.4) | 4 (5.9) |
Recency of SI relative to index ED visit | ||
No past month SI | 136 (38.7) | 12 (20.0) |
The last 24 h | 143 (40.7) | 41 (68.3) |
Between 24 h and 1 month | 72 (20.6) | 7 (11.7) |
Recency of Past Attempt Before Index ED Visit, Full Sample
ED Disposition, Full Sample
Past Attempt and Past Month SI
Past Attempt and No Past Month SI
Reattempt Post‐ED‐Discharge and Recency of Past Attempt/Ideation
Associations Between Recency of Past Attempt and Reattempt
Recency of past suicide attempt prior to index ED visit | Adjusted OR (95% CI) | p‐value | Adjusted OR (95% CI)c | p‐valuec |
---|---|---|---|---|
Past week | 4.8 [1.7–16.2]d | 0.01 | 3.7 [1.3–12.8]e | 0.02 |
1 week to 3 months | 3.1 [1.1–10.4]e | 0.04 | 2.8 [1.0–9.6] | 0.07 |
3–6 months | 2.6 [0.7–9.8] | 0.13 | 2.6 [0.7–9.6] | 0.14 |
6 months to 1 year | 3.0 [0.8–11.0] | 0.08 | 3.0 [0.8–1.0] | 0.09 |
Over 1 year | Reference | Reference | Reference | Reference |
Associations Between Recency of SI and Reattempt
Recency of suicidal ideation prior to index ED visit | Adjusted OR (95% CI) | p‐value |
---|---|---|
Past 24 h | 2.8 [1.1–7.6]c | 0.04 |
24 h to 1 month | 0.9 [0.3–2.5] | 0.90 |
No past month SI | Reference | Reference |
DISCUSSION
Clinical Implications: Detecting and Managing Suicide Risk
Limitations
CONCLUSION
Footnotes
REFERENCES
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