Emergency department assessment of adolescent suicide attempters: factors related to short-term follow-up outcome.
Empirical data to help gauge risk for repeat suicide attempts and noncompliance with outpatient psychiatric care among adolescent suicide attempters discharged from emergency departments is scarce. In this study, 62 adolescent suicide attempters discharged from a regional trauma center serving an urban/suburban area with a broad range of social classes were followed up at three months after their attempts to assess treatment compliance and repeat attempts. Information regarding suicidal intent and characteristics of the attempt were collected by emergency physicians at the time of the attempt. Parental ratings of adolescent functioning were also collected. At three-month follow-up, none of the adolescents had completed suicide; 7% made a repeat suicide attempt, 16% never followed through with outpatient psychiatric appointments, 15% attended one session, and 21% went to only two appointments. A prior suicide attempt, alcohol use at the time of the attempt, and greater planning of the suicide attempt were associated with better compliance with outpatient psychiatric treatment. None of the variables predicted repeat attempts. Parental reports of an adolescent's physical fighting and health problems of a family member were related to referral failure. Clinical implications are discussed.
Spirito
A
A
Rhode Island Hospital/Brown University School of Medicine, Providence 02903.
Lewander
W J
WJ
Levy
S
S
Kurkjian
J
J
Fritz
G
G
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011613:Psychotherapy; D012237:Rhode Island; D012307:Risk Factors; D013315:Stress, Psychological; D013406:Suicide, Attempted / Q000523:psychology*; D011795:Surveys and Questionnaires; D014193:Trauma Centers