Characteristics of Adolescents and Young Adults Visiting an Emergency Department Due to Self-Harm or Suicide Attempts: Risk Factors for Severe Medical Outcome and Short-Term Revisits.

内容摘要

Suicide and self-harm among adolescents or young adults represent major public health issues, characterized by high recurrence rates and significant social burdens. This study aimed to identify demographic and clinical characteristics, as well as risk factors associated with severe medical outcomes and short-term revisits among this population. A retrospective analysis was performed on 1,445 adolescents or young adults (≤ 24 years old) who visited an emergency department (ED) designated as a regional psychiatric emergency center in Seoul, Korea, for suicide attempts or self-harm from January 2015 to December 2022. Data collected included demographics, medical and psychiatric histories, details of the incidents, and clinical outcomes. Severe medical outcomes were defined as admissions to non-psychiatric wards, intensive care units, surgical hospitalization, or transfers. Short-term ED revisits within 60 days were analyzed. Multivariable logistic regression was employed to identify independent factors associated with severe medical outcomes and ED revisits. Among the study participants, 1,090 (75.4%) were female, and most incidents were impulsive and non-lethal. Severe medical outcomes occurred in 8.7% of visits and were significantly associated with planned suicide attempts (adjusted odds ratio [aOR], 1.92; 95% confidence interval [CI], 1.02-3.62) and the use of high-lethality methods such as pesticides, chemicals, inhalation, hanging, and falls. Short-term revisits within 60 days occurred in 7.1% of patients, with significant factors associated with revisits including female gender (aOR, 1.93; 95% CI, 1.04-3.55), living alone (aOR, 1.57; 95% CI, 1.00-2.44), expressed requests for help (aOR, 1.68; 95% CI, 1.04-2.74), and history of psychiatric treatment (aOR, 2.41; 95% CI, 1.15-5.04). Targeted ED-based and community interventions, along with timely psychiatric care, tailored to the specific characteristics and risk profiles of adolescents or young adults may help reduce severe outcomes and prevent repeat self-harm and suicide attempts.