Suicidal children and adolescents with first emergency room presentations: predictors of six-month outcome.
OBJECTIVE
To examine risk of future documented suicide attempts and emergency room (ER) returns among children and adolescents with first suicidal ER presentations.


METHODS
A total of 548 consecutive ER presentations of suicidal 5- to 19-year-olds to a Canadian center over a 1-year period (1997-1998) were reviewed. Relative risk analyses were performed on 224 first-time patients (mean age 14.6+/-2.1) to determine the strength of associations between predictors and outcomes (ER return and suicide attempts).


RESULTS
At 6-month follow-up, 32.6% (n = 73) had returned to the ER, 24.1% (n = 54) had a documented suicide attempt, and 14.3% (n = 32) required psychiatric hospitalization. Predictors for both ER return and future documented suicide attempts included 15- to 19-year age range, past foster/group home placement, past mental health care, a suicide plan, reported mood symptoms, sobriety at ER visit, and general substance use. Child welfare guardianship and abuse history were also predictors of ER returns.


CONCLUSIONS
Clinicians should be aware of these risk factors when assessing and managing suicidal youths with first ER presentations.
Stewart
S E
SE
University of Ottawa, Ontario, Canada.
Manion
I G
IG
Davidson
S
S
Cloutier
P
P
D000293:Adolescent; D000328:Adult; D002648:Child; D004637:Emergency Services, Psychiatric; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D012307:Risk Factors; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology* / Q000706:statistics & numerical data