Coexistence of Substance Abuse among Emergency Department Patients Presenting with Suicidal Ideation

Tadros, Allison; Sharon, Melinda; Crum, Michael R.; Johnson, Reid C.; Quedado, Kimberly; Fang, Wei; Inaba, Hideo

doi:10.1155/2020/7460701

Cited by 9 publications

(6 citation statements)

References 12 publications

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“…In line with previous reports, substance misuse and STB were common clinical reasons for referrals among patients with multiple referrals 25 and coexisted in PER patients. 26 Against the scarcity of knowledge of the suicidal process, 27 there was a strong temporal association between suicide ideation/plan and suicide attempt, with respect to which four findings warrant attention. First, STB among PER patients was persistent and led to repeated referrals, confirming earlier findings, 10 , 14 often within a short period.…”

Section: Discussionmentioning

confidence: 99%

Transition to suicide ideation and attempt among emergency room patients

Yurdadön,

Bruffaerts,

Sabbe

et al. 2024

BJPsych open

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Background Suicidal thoughts and behaviours (STB) represent a persistent and serious public health problem, and suicide is among the leading causes of death worldwide. We focus on predictors of transition rates and time courses through the STB spectrum among psychiatric emergency room (PER) patients. Aims We aimed to investigate (a) whether currently suicidal patients had prior referrals to the PER, (b) for which reason they were previously referred to the PER and (c) the timing of this referral. Method We performed a retrospective study spanning 20 years with 24 815 PER referrals. Descriptive statistics of patients’ sociodemographic and clinical characteristics are provided and expressed as weighted proportions and means. Logistic regression was used to identify risk profiles of patients who had a higher chance of being referred for reasons of STB given their PER history. Multiple imputation and data weighting techniques were implemented. Results STB among PER patients was persistent and led to repeated referrals (up to five times more likely), often within a short period (18% <1 month). Those previously referred for ideation/plan had 66% higher risk of making the transition to suicide attempt, with 25% making this transition within a month after previous referral. This is similar to the transition from depressed mood to suicide ideation/plan. Conclusions STBs in PER patients are persistent and lead to repeated referrals, often within a short period, including transitions to more severe forms of STB.

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Section: Discussionmentioning

confidence: 99%

Transition to suicide ideation and attempt among emergency room patients

Yurdadön,

Bruffaerts,

Sabbe

et al. 2024

BJPsych open

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“…This study has some limitations. First, while we chose diagnostic codes used in the published literature to identify patients with suicidality [17][18][19][20][21][22][23][24][25], these ICD-10 codes are nonetheless intended for patient billing. Consistent with previous literature, we included codes for suicide and for intentional self-harm.…”

Section: Discussionmentioning

confidence: 99%

“…The study received exempt status from the Institutional Review Board at BCH. Suicidality is defined using International Classification of Diseases, 10th Revision (ICD-10) codes selected from those used in prior studies [17][18][19][20][21][22][23][24][25]. We included discharge diagnosis and billing codes for suicidal ideation (R45.851), suicide attempt (T14.91*), and codes for intentional self-harm (S1 Table in S1 File).…”

Section: Methodsmentioning

confidence: 99%

Emergency department visits and boarding for pediatric patients with suicidality before and during the COVID-19 pandemic

Zipursky,

Olson,

Bode

et al. 2023

PLoS ONE

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Objective To quantify the increase in pediatric patients presenting to the emergency department with suicidality before and during the COVID-19 pandemic, and the subsequent impact on emergency department length of stay and boarding. Methods This retrospective cohort study from June 1, 2016, to October 31, 2022, identified patients ages 6 to 21 presenting to the emergency department at a pediatric academic medical center with suicidality using ICD-10 codes. Number of emergency department encounters for suicidality, demographic characteristics of patients with suicidality, and emergency department length of stay were compared before and during the COVID-19 pandemic. Unobserved components models were used to describe monthly counts of emergency department encounters for suicidality. Results There were 179,736 patient encounters to the emergency department during the study period, 6,215 (3.5%) for suicidality. There were, on average, more encounters for suicidality each month during the COVID-19 pandemic than before the COVID-19 pandemic. A time series unobserved components model demonstrated a temporary drop of 32.7 encounters for suicidality in April and May of 2020 (p<0.001), followed by a sustained increase of 31.2 encounters starting in July 2020 (p = 0.003). The average length of stay for patients that boarded in the emergency department with a diagnosis of suicidality was 37.4 hours longer during the COVID-19 pandemic compared to before the COVID-19 pandemic (p<0.001). Conclusions The number of encounters for suicidality among pediatric patients and the emergency department length of stay for psychiatry boarders has increased during the COVID-19 pandemic. There is a need for acute care mental health services and solutions to emergency department capacity issues.

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“…Both depression and bipolar disorder are well-known risk factors for suicidal thinking [ 32 , 33 ]. Substance abuse has been commonly reported to coexist with suicidal ideation [ 34 ]. Insomnia symptoms were also uniquely associated with the frequency of suicidal ideation in a previous study [ 35 ], consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study

Oh,

Park,

Song

2023

Psychiatry Investig

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Objective Chronic pain increases the risk of suicide because it is often accompanied by depressive symptoms. However, the existing information regarding suicidal thinking in patients with chronic pain such as spinal conditions is insufficient. We aimed to examine the prevalence of suicidal thinking and the factors associated with it among patients with spinal conditions.Methods Data from the National Health Insurance Service database in South Korea were used in this population-based, cross-sectional study, and 2.5% of adult patients diagnosed with spinal conditions (low back pain and/or neck pain) between 2018 and 2019 were selected using a stratified random sampling technique. Patient Health Questionnaire–9 was used to determine the presence of suicidal thoughts and depressive symptoms.Results 33,171 patients with spinal conditions were included in this study. Among them, 5.9% had suicidal thinking and 20.7% had depressive symptoms. In the multivariable logistic regression model, old age, male sex, and employment were associated with a decreased prevalence of suicidal thinking. Current smokers, previous smokers, medical aid program recipients, and patients with mild-to-moderate or severe disability showed increased suicidal thinking. Underlying depression, bipolar disorder, insomnia disorder, and substance abuse were also associated with increased suicidal thinking.Conclusion In South Korea, 5.9% and 20.7% of patients with spinal conditions had suicidal thoughts and depressive symptoms, respectively. Some factors were associated with an increased prevalence of suicidal thoughts among patients with spinal conditions. Our results suggest that screening for these factors can help prevent suicide in patients with spinal conditions.

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Coexistence of Substance Abuse among Emergency Department Patients Presenting with Suicidal Ideation

Cited by 9 publications

References 12 publications

Transition to suicide ideation and attempt among emergency room patients

Transition to suicide ideation and attempt among emergency room patients

Emergency department visits and boarding for pediatric patients with suicidality before and during the COVID-19 pandemic

Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study

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