A new study shows an association between visits to the emergency department of a hospital with medical complaints and an increased risk of suicide in patients between the ages of 15 and 29.
According to researchers, the study’s findings underscore the importance of emergency departments (EDs) in suicide prevention.
Suicide is the second leading cause of death for youth, with mental disorders and substance abuse as the two leading risk factors. Approximately 40 percent of those above 16 who die from suicide visit EDs in the year before their deaths, the researchers report, adding 60 percent of them receive medical diagnoses other than mental health or substance abuse.
“Young people presenting to the ED for certain medical conditions are at an increased risk of subsequent self-directed violence,” said lead investigator Jing Wang, M.D., M.P.H., Division of Violence Prevention, National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention in Atlanta. “An awareness of these medical encounters may help guide screening efforts for suicide prevention in clinical settings.”
According to researchers, the new study addresses important gaps in previous research by identifying the medical reasons triggering youth ED visits that are associated with higher risk of subsequent suicidal behavior.
Using data from six states — Florida, New York, Nebraska, Vermont, Iowa, and Massachusetts — from databases sponsored by the Agency for Healthcare Research and Quality, investigators followed more than 2 million teens and young adults who visited EDs for medical reasons during 2012-2013. Of that group, nearly 8,500 subsequently engaged in self-directed violence within six months of the initial visit, according to the study’s findings.
Teens and young adults who presented with diagnoses of epilepsy or seizures, or visited two or more times for various types of pain, syncope (fainting), or vomiting had a three to nine fold increased risk of suicidal behavior in the following six months, the study discovered.
Individuals who visited three or more times for dental complaints were also found to be more likely to engage in subsequent self-directed violence, the researchers noted.
The findings also showed that half of the self-directed violence events occurred within 42 days of the initial ED visit.
Identification of the heightened risk for suicide following visits for these medical conditions provides ED clinicians with a critical window of opportunity for detection, assessment, and intervention, researchers said. The broad number of physical health conditions associated with an increased risk of subsequent suicidal behavior may help inform and support expanded screening and suicide prevention strategies in EDs, they added.
A limitation of the study is that about 70 percent of people who engage in self-directed violence do not seek medical assistance, researchers said.
The study was published in the American Journal of Preventive Medicine.